Functional facial and tongue movement disorders

Area of Science:

• Neurology
• Movement Disorders

Background:

• Functional movement disorders (FMDs) affecting facial muscles are frequently underdiagnosed due to incompletely understood phenomenology.
• These conditions are more prevalent than previously assumed.

Purpose of the Study:

• To elucidate the phenomenology of facial FMDs.
• To outline clinical and instrumental diagnostic approaches for facial FMDs.
• To differentiate facial FMDs from organic neurological disorders.

Main Methods:

• Review of clinical features characteristic of facial FMDs.
• Identification of supportive demographic and comorbidity factors.
• Discussion of differential diagnosis with organic conditions like blepharospasm, oromandibular dystonia, and hemifacial spasm.

Main Results:

• Facial FMDs present with features such as fixed unilateral contractions, inconsistent patterns, somatoform findings, and response to suggestion or psychotherapy.
• Rapid onset, spontaneous remissions, and normal neurological examinations are noted.
• Supportive factors include younger age, female gender, and comorbidities like depression or fibromyalgia.

Conclusions:

• Recognizing the specific phenomenology and diagnostic features of facial FMDs is crucial for accurate diagnosis.
• Distinguishing facial FMDs from organic mimics requires careful clinical evaluation and consideration of supportive features.
• Improved characterization of facial FMDs will enhance clinical recognition and management.