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Related Experiment Video

Updated: Mar 14, 2026

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Functional dystonia.

D A Schmerler1, A J Espay1

  • 1Gardner Family Center for Parkinson's Disease and Movement Disorders, Department of Neurology, University of Cincinnati, Cincinnati, OH, USA.

Handbook of Clinical Neurology
|October 11, 2016
PubMed
Summary

Functional dystonia, though challenging to diagnose, shares pathophysiologic traits with organic dystonia. Early recognition and therapy, including physical and cognitive approaches, are crucial for managing this neurologic condition.

Keywords:
cognitive behavioral therapyconversion disorderdystoniafunctional dystoniafunctional movement disorderpsychogenicpsychogenic dystoniapsychogenic movement disordersomatization disorder

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Area of Science:

  • Neurology
  • Movement Disorders
  • Psychogenic Disorders

Background:

  • Functional dystonia diagnosis currently lacks a definitive electrophysiologic test but can be established using clinical criteria.
  • Distinctive regional phenotypes, including specific limb and axial presentations, are recognized.
  • Pathophysiology overlaps with organic dystonia, involving cortical/spinal inhibition and somatosensory processing deficits.

Purpose of the Study:

  • To review diagnostic criteria and clinical features of functional dystonia.
  • To explore the pathophysiologic underpinnings and neuroimaging findings.
  • To discuss management strategies and prognosis.

Main Methods:

  • Clinical criteria-based diagnosis.
  • Review of existing literature on pathophysiology and neuroimaging (PET, fMRI).
  • Discussion of therapeutic approaches including patient debriefing, physical therapy, and psychotherapy.

Main Results:

  • Specific regional dystonic patterns are identifiable.
  • Shared pathophysiologic mechanisms with organic dystonia, including altered inhibition and sensory processing.
  • Emerging evidence of regional blood flow and activation pattern abnormalities.

Conclusions:

  • Compassionate diagnosis and patient acceptance are vital for treatment success.
  • Physical therapy and cognitive behavioral therapy show potential benefits.
  • Early diagnosis and intervention are key to minimizing disability and iatrogenic harm.