Psychogenic movement disorders

Summary Psychogenic movement disorders are common, but the diagnosis may be difficult. Visual appearance alone is typically not sufficient to make a diagnosis, but such information is certainly important. That a movement is bizarre can be helpful, but still must be considered thoughtfully since orga...

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Bibliographic Details
Published in:Parkinsonism & related disorders 2012, Vol.18, p.S155-S157
Main Authors: Hallett, Mark, Weiner, William J, Kompoliti, Katie
Format: Article
Language:English
Subjects:
Animals
Conversion disorder
Dystonic Disorders - diagnosis
Dystonic Disorders - physiopathology
Dystonic Disorders - psychology
Humans
Movement Disorders - diagnosis
Movement Disorders - physiopathology
Movement Disorders - psychology
Myoclonus
Neurology
Psychogenic movement disorder
Psychogenic parkinsonism
Psychophysiologic Disorders - diagnosis
Psychophysiologic Disorders - physiopathology
Psychophysiologic Disorders - psychology
Somatization
Somatoform Disorders - diagnosis
Somatoform Disorders - physiopathology
Somatoform Disorders - psychology
Tremor
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Summary:Summary Psychogenic movement disorders are common, but the diagnosis may be difficult. Visual appearance alone is typically not sufficient to make a diagnosis, but such information is certainly important. That a movement is bizarre can be helpful, but still must be considered thoughtfully since organic movement disorders can have endless variety. The diagnosis should rest on positive findings such as paroxysmal nature, maximum severity at or near onset, variability of tremor direction, frequency and amplitude, entrainment of tremor, distractability and suggestibility, and wildly swaying gait and balance problems with no falling. Psychogenic parkinsonism often poses a problem because of the relatively high frequency of overlap of psychogenic and organic disease. In regard to psychogenic parkinsonism, there are special features to look for. There might be tremor with kinetic movement as well as rest and posture, and finger tremor might be absent. With sequential movements, the sequence effect is typically lacking. Extreme slowness and grunting with great effort may be seen. Improvement in arm swing while running, a feature of organic parkinsonism, may not be seen.
ISSN:1353-8020
1873-5126
DOI:10.1016/S1353-8020(11)70048-7