Functional movement disorders

Galli, Silvio; Béreau, Matthieu; Magnin, Éloi; Moulin, Thierry; Aybek, Selma

doi:10.1016/j.neurol.2019.08.007

Cited by 17 publications

(15 citation statements)

References 97 publications

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“…Various studies reported that the most common presentations of FMD were tremor (40.6–50% of FMD patients) and dystonia (17.2–18%), with parkinsonism, tics, myoclonus and chorea being less common ( 3 , 21 – 24 ). Our results confirmed functional dystonia and tremor as the most frequent symptoms, both initially (67 and 26%, respectively), and at final examination (71 and 36% patients, respectively).…”

Section: Discussionmentioning

confidence: 99%

“…The clinical features of FMD, including paroxysmal onset, waxing, and waning course, migration of symptoms to different body parts, together with possible symptom replacement (the resolution of one symptom can be followed by the appearance of another) ( 3 ), speak in favor of the unpredictable and often elusive nature of such disorders, leaving both patients and their physicians in the field of uncertainty. Furthermore, additional physical features (such as pain, fatigue, bladder, or bowel problems, etc), as well as psychiatric comorbidities, are usually associated with FND/FMD and can have significant impact on outcome ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

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Changes of Phenotypic Pattern in Functional Movement Disorders: A Prospective Cohort Study

et al. 2020

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Introduction: Functional movement disorders (FMD) refer to a group of movement disorders that present with clinical characteristics incongruent to those due to established pathophysiologic processes, as for example in the case of neurodegeneration or lesions. The aim of this study was to assess clinical features that contribute to the specific phenotypic presentations and disease course of FMD. Methods: The study consisted of 100 patients with FMD treated at Clinic for Neurology, Clinical Center of Serbia, who were longitudinally observed. Comprehensive clinical and psychiatric assessment was performed at the baseline, when initial FMD phenotype was defined. Follow-up assessment of phenotypic pattern over the time and clinical course was done after 3.2 ± 2.5 years at average. Results: We showed that 48% of FMD patients were prone to changes of phenotypic pattern during the disease course. Dystonia had tendency to remains as single and unchanged phenotype over the time (68.2%), while patients initially presented with Tremor, Gait disorder, Parkinsonism and Mixed phenotype were more susceptible to developing additional symptoms (62.5, 50, and 100%, respectively). Higher levels of somatoform experiences (p = 0.033, Exp(B) = 1.082) and higher motor severity (p = 0.040, Exp(B) = 1.082) at baseline assessment were associated with an increased likelihood of further enriching of FMD phenotype with additional functional symptoms. Also, these patients more frequently reported pain, and had higher scores on majority of applied psychiatric scales, together with more frequent presence of major depressive disorder. Conclusion: Results from this prospective study suggested tendency for progression and enrichment of functional symptoms in FMD patients over time. Besides functional core symptoms, other key psychological and physical features (like pain or multiple somatisations) were quite relevant for chronicity and significant dysability of FMD patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes of Phenotypic Pattern in Functional Movement Disorders: A Prospective Cohort Study

et al. 2020

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“…The DSM-5 added a clinical criterion in 2013, which allows a ''rule-in'' procedure in firming a diagnosis of FMDs so that it is no longer considered a diagnosis of exclusion. 2 Functional movement disorders account for even 15% of neurology outpatient clinics, which are more common in women 1,2 and range from 17 to 83 years old. 1 The incidence of functional neurological disorders is 4 to 12 of 100,000 per year.…”

Section: The Pretender Of Parkinson's Disease: What Neurologists Need To Know About Functional Movement Disordersmentioning

confidence: 99%

“…Functional movement disorders (FMDs) comprise a broad range of clinical symptoms not explained by a classical neurological disease. Tremor is the most common symptom in FMDs 1 , 2 followed by dystonia, myoclonus, balance disorder, bradykinesia, cranial movement, hemifacial spasms, restless legs, and so on. FMDs are often categorized as “psychogenic,” and the psychological parkinsonism is about 10% of patients with FMDs.…”

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confidence: 99%