Functional Motor Disorders Mimicking Symptoms Upon Resolution of Cerebrovascular Disease

Functional motor disorders encompass a variety of manifestations characterized by abnormal movements that are clinically incongruent with those known to be caused by neurological diseases.

We report 2 cases in which functional motor disorders developed after complete recovery of motor symptoms originating from underlying vascular brain lesions. The first case describes a young woman who developed a motor and sensory hemisyndrome after surgical removal of a postrolandic cavernoma. The second describes a 16-year-old girl who presented with a mixed component tremor after ventricular derivation and endovascular embolization for rupture of a brainstem arteriovenous malformation.

Motor symptoms and signs attributed to an underlying lesion may trigger "pure" functional motor disorders. In such cases, the differential diagnosis may be even more challenging. However, diagnosis of a functional rather than a defined structural disorder can be achieved by a "positive diagnostic process," considering the findings of internal inconsistency and incongruity.