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Suggestibility as a valuable criterion for laboratory-supported definite functional movement disorders
Gerard Saranza1,2, Daniel Vargas-Mendez1,3, Anthony E Lang1,4
1Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada.
Objective:
To evaluate the application of suggestibility in electrophysiologic studies as a tool to increase the diagnostic certainty of "laboratory-supported definite" FMD.
Methods:
We retrospectively reviewed the electrophysiologic studies performed in our center on patients with FMD. Recordings where suggestibility was included in the test battery were then selected.
Results:
We present three cases with equivocal clinical features, but with findings on electrophysiologic studies that were consistent with "laboratory-supported definite" FMD.
Conclusion:
When combined with other tests, demonstration of suggestibility in electrophysiologic studies may increase the accuracy in differentiating functional from organic movement disorders.
Significance:
This case series is an essential first step in evaluating the applicability of suggestibility as an electrophysiologic criterion to aid in the diagnosis of FMD. Application in a larger cohort, incorporation in a test battery, and validation studies, including quantitative evaluation of suggestibility, are required to assess the reliability and the added value of this test.
