Psychogenic Movement Disorders

Miyasaki, Janis; Daniel, SE; Gálvez‐Jiménez, Néstor; Lang, Anthony E.

doi:10.1017/s0317167100003292

Cited by 88 publications

(104 citation statements)

References 25 publications

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“…When evaluated this way, the predominant types of PMD are tremor (30%-50%), dystonia and myoclonus (about 20%-25% each), gait disorder (roughly 10%), and less frequently parkinsonism (about 5%). 46 Described in general, however, PMD can present with a great variety of movements and can also affect speech. 47 Moreover, in a number of patients there can be other features such as give-way weakness or psychogenic patterns of sensory loss and convergence spasm might be present on eye movement examination.…”

Section: Chronic Painmentioning

confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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Purpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. Recent findings:Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients. Neurol Clin Pract 2016;6:138-149 N eurologic symptoms due to a functional or psychogenic cause are common in clinical practice, accounting for up to 16% of patients presenting to neurology outpatient clinics, depending on the clinical definitions and methodology used for case ascertainment.1,2 The yearly costs of patients with medically unexplained symptoms in the United States have been estimated at approximately $256 billion per year.3 Despite their prevalence and associated economic and social burden, appropriate treatments for these disorders are an unmet need. This may reflect the absence of research interest and lack of discourse between neurology and psychiatry regarding these patients. Notably, although approximately 50% of the patients with somatoform disorders are identified by neurologists at the time of first contact, only 1.5% are referred to a psychiatrist or a psychologist.

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Section: Chronic Painmentioning

confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…Parkinson's disease) in other relatives (Miyasaki et al, 2003;) More frequently, PMDs are encountered in the context of a second coexisting psychiatric illness. Feinstein and colleagues followed 88 patients suffering from psychogenic movement disorders, over an average of 3 years.…”

Section: Wwwintechopencommentioning

confidence: 99%

“…In general, the manner of onset characterizes the clinical presentation of PMDs (Table 2.B): symptoms appear abruptly, frequently in the context of precipitating factors and, the highest disability and severity are reached quickly (Feinstein et al, 2001). Important specifics of PMDs are an inconsistent character of movement (unusual presentation in amplitude, frequency, distribution), and they may increase with attention or decrease with distraction (Miyasaki, 2003). A deliberate slowness of movement is incongruent with an www.intechopen.com organic movement disorders, as well as simultaneous occurrence of variegated abnormal movements and disfunctions, and peculiarly, patients may seem to struggle and put in more effort than needed to complete the task (Hinson & Blacke Haren 2006;Bhatia & Schneider 2007).…”

Section: Documented Psychogenicmentioning

confidence: 99%

“…Finally, the common occurrence of movement disorders complicating primary mental illness and their treatment makes it important for psychiatrists to be able to recognize the various movement disorders, some of which have singular phenomenology such as tardive akathisia, tardive dystonia, tourettism and some unusual form of parkinsonism or tremor (Factor et al, 2005 Table 2. General clues suggesting that a movement disorder may be psychogenic (Miyasaki et al, 2003;Lang, 2006) www.intechopen.com…”

Section: Documented Psychogenicmentioning

confidence: 99%

“…In general, psychogenic dystonia represents only approximately 5% of subjects with dystonia, but in most centers, it is the second most commonly encountered among PMDs and accounts for 20% to 50% of cases (Miyasaki et al, 2003). Psychogenic dystonia, classified as a secondary dystonia, largely remains a clinical diagnosis and there are no physiologic tests available that distinguish a psychogenic aetiology from an organic form (Peckham & Hallett, 2009).…”

Section: Psychogenic Dystoniamentioning

confidence: 99%

See 2 more Smart Citations

Psychogenic Movement Disorders

Dallocchio¹

2011

Psychiatric Disorders - Trends and Developments

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Psychogenic Movement Disorders: Gait Is a Give‐Away!

Balint

Winsen

Bhatia

et al. 2014

Movement Disord Clin Pract

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The aim of this article is to point out that an incongruity of gait disorder (either in relation to the presenting movement disorder or incongruity with any type of organic gait disorder) is a useful clue in diagnosing psychogenic movement disorders. To illustrate this, we present a case series of patients with various types of psychogenic movement disorders (rest tremor, myoclonus, dystonia, and chorea). Incongruity of the walking pattern with the presenting movement disorder was a revealing diagnostic clue in all cases. “Incongruity” is currently a main plank in the diagnosis of psychogenic conditions. Our series emphasizes that incongruity of the gait pattern may be the most important sign in a patient where it is otherwise difficult to establish whether the movement disorder is congruous or incongruous with an organic disorder.

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Psychogenic Movement Disorders

Cited by 88 publications

References 25 publications

Psychogenic nonepileptic seizures and movement disorders

Psychogenic nonepileptic seizures and movement disorders

Psychogenic Movement Disorders

Psychogenic Movement Disorders: Gait Is a Give‐Away!

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