Treatment of Functional (Psychogenic) Movement Disorders

Ricciardi, Luisa; Edwards, Mark J.

doi:10.1007/s13311-013-0246-x

Cited by 61 publications

(59 citation statements)

References 47 publications

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“…Other proposed treatments may have more overlap between PNES and PMD, for example pharmacologic approaches, psychodynamic psychotherapy, complementary medical treatments (acupuncture, hypnosis), and proposed experimental treatments (e.g., transcranial magnetic stimulation). While the interested reader is referred elsewhere for an overview of the possible treatments in PNES 60 and PMD, 63 there is clearly an unmet need both for well-designed clinical trials of established treatments and development of novel treatment approaches, especially for severely affected patients who are refractory to currently available treatments.…”

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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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confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…For example, neurologists may make a diagnosis of a functional (psychosomatic, psychogenic, conversion) neurologic disorder based on inconsistency among reported symptoms, a normal elemental neurologic examination, and positive examination signs. 12 Most neurologists have developed their own approach to these patients, often tailored to the patient's individual presentation. In addition to strategies described above, 8 consistent documentation of diagnosis and plan is advised.…”

Section: Documenting Sensitive Diagnoses (Potential and Actual)mentioning

confidence: 99%

“…In movement disorders, the term "functional movement disorder" has been proposed as being more acceptable to patients while being a more scientifically accurate term than the more established "psychogenic movement disorder." 13,14 Frameworks on how to communicate these difficult diagnoses and management plans have been proposed 12 (see also neurosymptoms.org).…”

Section: Documenting Sensitive Diagnoses (Potential and Actual)mentioning

confidence: 99%

Sharing notes with patients

Weathers

et al. 2017

Neur Clin Pract

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Improved patient engagement is a critical consideration in the new payment climate. Releasing progress notes for patients to view may improve patient involvement and engagement in their care. Patients perceive benefit from viewing physician progress notes. As initial studies involved only primary care physicians, specialist physicians may have specific considerations when releasing notes to patients. This article provides a framework for neurologists to implement a note release policy in their practice.

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“…Supportive treatments include physical therapy, psychotherapy, physical exercise, and self-relaxation techniques [76][77][78][79][80]. Occasionally, antidepressants are used in patients with depressive symptoms [81,82]. Despite all interventions, some patients continue to have symptoms [83].…”

Section: Management and Outcomementioning

confidence: 99%

Functional Movement Disorders: Updated Overview

Subki¹,

Alkahtani²,

Alfayez³

et al. 2017

J Pediatr Care

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Functional movement disorders are relatively common neurological manifestations that are not related to a known neurological or a medical diagnosis. We aim to present an updated overview of this topic and present important diagnostic tips and pitfalls in the management of theses potentially puzzling presentations. Particularly, as such psychosomatic disorders could simulate known disorders, including tremor, paralysis, seizures, or ataxia. This often results in excessive, unnecessary and costly investigations, which may in turn further enhance the sick role and complicates the management. Early recognition and prompt intervention are needed to prevent social and academic disruptions, and hence a debilitating outcome.

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Treatment of Functional (Psychogenic) Movement Disorders

Cited by 61 publications

References 47 publications

Psychogenic nonepileptic seizures and movement disorders

Psychogenic nonepileptic seizures and movement disorders

Sharing notes with patients

Functional Movement Disorders: Updated Overview

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