Neurophysiologic studies of functional neurologic disorders

Hallett, Mark

doi:10.1016/b978-0-12-801772-2.00006-0

Cited by 29 publications

(27 citation statements)

References 81 publications

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“…Its theoretical concept of a disorder with the functioning of the nervous system is implicit (19) but it has been argued that the term is misleading on that basis, as the symptoms should properly be described as "dysfunctional" (9). Finally, that aetiological neutrality may not always work in its favour when it becomes clear that some would extend the term to feigned conditions such as factitious disorder (11,27).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Conversion disorder: A systematic review of current terminology

Ding

Kanaan

2017

General Hospital Psychiatry

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Objective: It has been argued that the label given to unexplained neurological symptoms is an important contributor to their often poor acceptance, and there has been recent debate on proposals to change the name from Conversion Disorder. There have been multiple studies of layperson and clinician preference and this article aimed to review these.Design: Multiple databases were searched using terms including "conversion disorder" and "terminology", and relative preferences for the terms extracted.Results: Seven articles were found which looked at clinician or layperson preferences for terminology for unexplained neurological symptoms. Most neurologists favoured terms such as "functional" and "psychogenic", while laypeople were comfortable with "functional" but viewed "psychogenic" as more offensive; "Non-epileptic/organic" was relatively popular with both groups.Conclusions: "Functional" is a term that is relatively popular with both clinicians and the public. It also meets more of the other criteria proposed for an acceptable label than other popular terms -however the views of neither psychiatrists nor actual patients with the disorder were considered.

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Section: Accepted Manuscriptmentioning

confidence: 99%

Conversion disorder: A systematic review of current terminology

Ding

Kanaan

2017

General Hospital Psychiatry

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“…This is apparent clinically, and physiological evidence for this comes from abnormal modulation of beta desynchronization in a choice reaction time task . Patients with functional myoclonus show a Bereitschaftspotential (BP) prior to their involuntary jerks . The BP was originally described to precede voluntary movement and largely comes from activation of the premotor cortex and supplementary motor area.…”

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confidence: 99%

“…Moreover, stimulus‐sensitive functional myoclonus behaves like voluntary reaction time movements. Functional tremor behaves in all ways like voluntary rhythmic movements . Indeed, if a patient is asked to make a voluntary rhythmic movement of another body part, the involuntary tremor entrains to the voluntary movement.…”

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confidence: 99%

“…6 Patients with functional myoclonus show a Bereitschaftspotential (BP) prior to their involuntary jerks. 7 The BP was originally described to precede voluntary movement and largely comes from activation of the premotor cortex and supplementary motor area. This shows that functional myoclonus uses the same final mechanism as voluntary movement.…”

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confidence: 99%

“…Functional tremor behaves in all ways like voluntary rhythmic movements. 7 Indeed, if a patient is asked to make a voluntary rhythmic movement of another body part, the involuntary tremor entrains to the voluntary movement. Hence, the generation of functional myoclonus and tremor appear to arise from unwanted, top-down influences on the normal voluntary motor system.…”

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confidence: 99%

See 2 more Smart Citations

Functional movement disorders: Is the crisis resolved?

Hallett

2019

Movement Disorders

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Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

et al. 2022

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Background and objective People with functional motor disorder (FMD) report triggers—sensory or motor-induced stimuli that exacerbate or initiate paroxysmal occurrences of their movement disorder. These are a distinct phenomenon from precipitating factors occurring at the initial onset of the disorder. We aimed to assess triggers in FMD and understand their relevance to paroxysmal variability often seen in FMD. Methods We enrolled consecutive outpatients with a definite diagnosis of FMD. Each patient underwent a detailed clinical evaluation also including the presence of trigger factors and video-recordings both during neurological examination and physiotherapy treatment. Patients were classified as having “triggers” (T-FMD) or “not having triggers” (NoT-FMD) as well as “paroxysmal” compared to “persistent with paroxysmal variability”. Results The study sample was 100 patients (82% female) with FMD; the mean age at onset was 41 years. Triggers were observed in 88% of patients and in 65 of these the FMD was pure paroxysmal. The most common triggers were movement or physical exercise, followed by emotional, visual, touch, and auditory stimuli; 39 (44%) were isolated and 49 (56%) were combined triggers. Among the T-FMD patients, FMD were paroxysmal in 74% (n = 65) and persistent with paroxysmal variability in 26% (n = 23). The T-FMD patients were younger (p = 0.016) and had a gait disorder (p = 0.035) more frequently than the NoT-FMD patients. Discussion Triggers are frequent in FMD and may have diverse overlapping clinical presentations. In this sample, FMD was most often paroxysmal, suggesting the value of noting triggers as clinical clues in the diagnosis and rehabilitation of FMD.

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Neurophysiologic studies of functional neurologic disorders

Cited by 29 publications

References 81 publications

Conversion disorder: A systematic review of current terminology

Conversion disorder: A systematic review of current terminology

Functional movement disorders: Is the crisis resolved?

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

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