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How Do I Examine Patients With Functional Tremor?

Sarah C Lidstone1, Anthony E Lang1

  • 1Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease Toronto Ontario Canada.

Movement Disorders Clinical Practice
|July 7, 2020
PubMed
Summary

Functional tremor, a common functional movement disorder, is diagnosed using specific historical and examination findings. Neurophysiological studies aid diagnosis when clinical signs are unclear.

Keywords:
functional movement disorderfunctional neurological disorderfunctional tremor

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Area of Science:

  • Neurology
  • Movement Disorders

Background:

  • Functional tremor is the most frequent manifestation of functional movement disorders.
  • It can present alone or with other functional symptoms and abnormal movements.

Purpose of the Study:

  • To outline the diagnostic criteria for functional tremor.
  • To highlight key features in patient history, clinical examination, and neurophysiological studies.

Main Methods:

  • Diagnosis relies on identifying positive features in patient history.
  • Clinical examination reveals specific tremor characteristics.
  • Neurophysiological studies (electromyography, accelerometry) can support diagnosis.

Main Results:

  • Historical indicators include sudden onset, preceding events, variability, somatic symptoms, and failed treatments.
  • Examination signs involve tremor variability, coherence, and responsiveness to distraction and attention.
  • Neurophysiological studies provide laboratory support when clinical diagnosis is challenging.

Conclusions:

  • Functional tremor diagnosis is established through a combination of characteristic history, examination findings, and potentially neurophysiological data.
  • Recognizing these positive diagnostic features is crucial for accurate identification of functional tremor.