Positive signs of functional weakness

Tremolizzo, Lucio; Susani, Emanuela; Riva, Michele Augusto; Cesana, Giancarlo; Ferrarese, Carlo; Appollonio, Ildebrando

doi:10.1016/j.jns.2014.03.003

Cited by 17 publications

(11 citation statements)

References 37 publications

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“…For instance, in the lower extremity, Hoover's sign is the most commonly used test to assess functional weakness. Hoover's sign is present if the patient does not push down with the normal leg when lifting the "weak" leg [19,21,22]. Similarly, the "abductor sign" is another way to assess functional weakness of the lower extremity when the abduction of the "weak" hip becomes normal while the contralateral hip is abducting against resistance [20•, 21, 23].…”

Section: Neurological Assessment Of Conversion Disordermentioning

confidence: 99%

Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment

Tsui

Deptula

Yuan

2017

Curr Pain Headache Rep

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Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study. There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

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Section: Neurological Assessment Of Conversion Disordermentioning

confidence: 99%

Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment

Tsui

Deptula

Yuan

2017

Curr Pain Headache Rep

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“…A less well-validated test, this sign was described by Monrad Krohn, a Norwegian neurologist in 1922, showing that weak contraction of the latissimus dorsi muscle against resistance of the horizontally extended arm in hysterical patients disappears when patients are asked to cough [38].…”

Section: Monrad-krohn's Testmentioning

confidence: 99%

Functional Neurological Disorder Presenting as Stroke: A Narrative Review

Abdelnour¹,

El-Nagi²

2017

J Psychol Abnorm

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Functional neurological symptom disorder (FNSD) represents one of the disorders that are continuously being revised by the diagnostic and statistical manual of disease (DSM) due to the lack of certainty of some of its clinical characteristics. In the last 5 th edition (DSM5), 7 subtypes have been proposed, but not all of them potentially present as stroke mimics. Though both FNSD and stroke are common in clinical practice, the prevalence of functional stroke is not well-known. The diagnosis of FNSD does not rely on the mere absence of medical explanation, but on active demonstration of symptom incompatibility with a medical disorder. In this narrative review, we explore the literature on the prevalence of functional stroke, its clinical presentation and the validated clinical signs of incongruity, the risk factors and cultural differences of clinical presentation and differentiation of FNSD from malingering. We also review the role of neuroimaging in establishing the diagnosis as well as the evidence of thrombolysis safety and some of the psychosomatic models of disease.

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“…However, there may be many other forms of presentation, including weakness of distal or proximal limb segments. There are many exploratory tricks to uncover functional weakness (Stone et al, 2012, Tremolizzo et al, 2014). Close observation of how the patient activates the supposedly paretic limb during postural tasks may already be very informative.…”

Section: Functional Weaknessmentioning

confidence: 99%