scholarly journals Opinions and clinical practices related to diagnosing and managing functional (psychogenic) movement disorders: changes in the last decade

2020 ◽  
Vol 27 (6) ◽  
pp. 975-984 ◽  
Author(s):  
K. LaFaver ◽  
A. E. Lang ◽  
J. Stone ◽  
F. Morgante ◽  
M. Edwards ◽  
...  
Keyword(s):  
Movement Disorders ◽  
Clinical Practices ◽  
Psychogenic Movement Disorders

Clinical decision-making in functional and hyperkinetic movement disorders

Neurology ◽  
2016 ◽  
Vol 88 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Sandra M.A. van der Salm ◽  
Anne-Fleur van Rootselaar ◽  
Daniëlle C. Cath ◽  
Rob J. de Haan ◽  
Johannes H.T.M. Koelman ◽  
...  
Keyword(s):  
Decision Making ◽  
Medical History ◽  
Movement Disorders ◽  
Clinical Decision Making ◽  
Psychiatric Evaluation ◽  
Neurologic Examination ◽  
Diagnostic Challenge ◽  
Psychiatric Interview ◽  
Psychogenic Movement Disorders ◽  
First Impression

Objective:Functional or psychogenic movement disorders (FMD) present a diagnostic challenge. To diagnose FMD, clinicians must have experience with signs typical of FMD and distinguishing features from other hyperkinetic disorders. The aim of this study was to clarify the decision-making process of expert clinicians while diagnosing FMD, myoclonus, and tics.Methods:Thirty-nine movement disorders experts rated 60 patients using a standardized web-based survey resembling clinical practice. It provided 5 steps of incremental information: (1) visual first impression of the patient, (2) medical history, (3) neurologic examination on video, (4) the Bereitschaftspotential (BP), and (5) psychiatric evaluation. After full evaluation of each case, experts were asked which diagnostic step was decisive. In addition, interim switches in diagnosis after each informational step were calculated.Results:After full evaluation, the experts annotated the first impression of the patients as decisive in 18.5% of cases. Medical history was considered decisive in 33.3% of cases. Neurologic examination was considered decisive in 39.7%, the BP in 8%, and the psychiatric interview in 0.5% of cases. Most diagnostic switches occurred after addition of the medical history (34.5%). Addition of the neurologic examination led to 13.8% of diagnostic switches. The BP results led to diagnostic switches in 7.2% of cases. Psychiatric evaluation resulted in the lowest number of diagnostic switches (2.7% of cases).Conclusions:Experts predominantly rely on clinical assessment to diagnose FMD. Importantly, ancillary tests do not determine the final diagnosis of this expert panel. In general, the experts infrequently changed their differential diagnosis.

scholarly journals Paroxysmal non-kinesigenic dyskinesia, post-streptococcal syndromes and psychogenic movement disorders: a diagnostic challenge

2015 ◽  
Vol 2015 (mar20 2) ◽  
pp. bcr2014207449-bcr2014207449 ◽  
Author(s):  
E. Peila ◽  
P. Mortara ◽  
A. Cicerale ◽  
L. Pinessi
Keyword(s):  
Movement Disorders ◽  
Diagnostic Challenge ◽  
Psychogenic Movement Disorders

Psychogenic movement disorders in two children

2003 ◽  
Vol 18 (11) ◽  
pp. 1395-1397 ◽  
Author(s):  
Sibel Özekmekçi ◽  
Hulya Apaydin ◽  
Burçak Ekinci ◽  
Cengiz Yalçinkaya
Keyword(s):  
Movement Disorders ◽  
Psychogenic Movement Disorders
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