Functional movement disorders: Is the crisis resolved?

Hallett, Mark

doi:10.1002/mds.27713

Cited by 13 publications

(14 citation statements)

References 25 publications

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“…Increasing evidence support the notion that functional movement disorders are caused by malfunction in brain networks, making it difficult to differentiate organic from functional dystonia [ 1 , 11 ]. Abnormal connectivity between cognitive, limbic, and motor neural networks seems to occur in patients with functional movement disorders [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Dystonia is a clinical syndrome diagnosed largely by clinical phenomenology [ 1 ]. Because there are so many different clinical manifestations and causes, there is no specific examination criteria or simple algorithm for diagnosing dystonia [ 1 , 2 , 3 , 4 ]. Dystonia is characterized by patterned, directional, sustained, or intermittent muscle contractions causing abnormal dystonic postures, and repetitive twisting dystonic movements [ 2 , 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The critical step in order to diagnose organic dystonia is to rule out disorders that mimic dystonia due to orthopedic, neuromuscular, or psychogenic processes [ 1 , 2 , 5 , 6 ]. Functional (psychogenic) dystonia is a manifestation of functional movement disorders, which are part of the wide spectrum of functional neurological disorders [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…Functional neurological disorders account for over 16% of new patients referred to neurological clinics [ 8 ] and cause a long-term impairment in quality of life as in Parkinson’s disease [ 7 , 9 ]. Functional neurological symptom disorder is classified as an official term in Diagnostic and Statistical Manual of Mental Disorders (DSM)-V under the general category of somatic symptom and related disorders [ 10 , 11 ], and is clearly differentiated from factitious disorder and malingering [ 1 ]. Functional dystonia is the second most common condition in patients with functional movement disorders after functional tremors [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Can Pallidal Deep Brain Stimulation Rescue Borderline Dystonia? Possible Coexistence of Functional (Psychogenic) and Organic Components

et al. 2020

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The diagnosis and treatment of functional movement disorders are challenging for clinicians who manage patients with movement disorders. The borderline between functional and organic dystonia is often ambiguous. Patients with functional dystonia are poor responders to pallidal deep brain stimulation (DBS) and are not good candidates for DBS surgery. Thus, if patients with medically refractory dystonia have functional features, they are usually left untreated with DBS surgery. In order to investigate the outcome of functional dystonia in response to pallidal DBS surgery, we retrospectively included five patients with this condition. Their dystonia was diagnosed as organic by dystonia specialists and also as functional according to the Fahn and Williams criteria or the Gupta and Lang Proposed Revisions. Microelectrode recordings in the globus pallidus internus of all patients showed a cell-firing pattern of bursting with interburst intervals, which is considered typical of organic dystonia. Although their clinical course after DBS surgery was incongruent to organic dystonia, the outcome was good. Our results question the possibility to clearly differentiate functional dystonia from organic dystonia. We hypothesized that functional dystonia can coexist with organic dystonia, and that medically intractable dystonia with combined functional and organic features can be successfully treated by DBS surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Can Pallidal Deep Brain Stimulation Rescue Borderline Dystonia? Possible Coexistence of Functional (Psychogenic) and Organic Components

et al. 2020

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Entwicklung und inhaltliche Validierung eines Fragebogens für funktionelle Bewegungsstörungen

et al. 2021

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ZusammenfassungVon Kriegszitterern zu Teenies mit TikTok-Tics – funktionelle Bewegungsstörungen galten lange als motorischer Ausdruck seelischer Turbulenzen. Tatsächlich werden psychodynamische Modelle jedoch zunehmend durch neurophysiologische Erkenntnisse ergänzt, sodass die Kombination von Psychotherapie mit spezialisierter Physiotherapie an Bedeutung gewinnt. Bislang existiert allerdings kein störungsspezifisches Ergebnismaß, welches patientenrelevante Aspekte dieser vielfältigen Störung adäquat abbildet. Ein erster derartiger Fragebogen wurde entwickelt und in einem mehrstufigen Entwicklungsprozess inhaltlich validiert. Relevanz und Verständlichkeit der Items wurden zuerst durch ein Expertengremium und anschließend durch betroffene Patienten evaluiert und entsprechend angepasst. Der so konstruierte Fragebogen erlaubt erstmals eine inhaltlich valide Quantifizierung der subjektiven Beschwerden und Auswirkungen funktioneller Bewegungsstörungen. Als Nächstes erfolgt eine multizentrische teststatistische Validierung.

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Normale motorische Bewegungsabläufe wiedererlernen

Mainka¹,

Ganos²

2020

InFo Neurologie

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Functional movement disorders: Is the crisis resolved?

Cited by 13 publications

References 25 publications

Can Pallidal Deep Brain Stimulation Rescue Borderline Dystonia? Possible Coexistence of Functional (Psychogenic) and Organic Components

Can Pallidal Deep Brain Stimulation Rescue Borderline Dystonia? Possible Coexistence of Functional (Psychogenic) and Organic Components

Entwicklung und inhaltliche Validierung eines Fragebogens für funktionelle Bewegungsstörungen

Normale motorische Bewegungsabläufe wiedererlernen

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