A Survey of Functional Movement Disorders at the National Institutes of Health (P1.073)

OBJECTIVE: To better characterize the clinical presentation of functional movement disorders. BACKGROUND: Functional (psychogenic) movement disorders are receiving greater attention as valid and treatable neurologic disorders. Unfortunately, the often long list of complaints with variable presentations may hamper timely diagnosis and treatment. METHODS: We reviewed 113 charts retrospectively of patients presenting to the National Institutes of Health. Patients were referred from 44 states and the District of Columbia, with the majority presenting from the local Washington D.C. metropolitan area. Most patients were diagnosed by clinical history and neurologic examination, looking specifically for distractibility, entrainabilty and variability of movements. Physiologic testing, including EEG/EMG with back averaging, weighted tremor analysis, blink reflex testing, and paired associative stimulation were used when the final diagnosis was ambiguous. RESULTS: Among the cases reviewed, the most common presenting symptoms were tremor (45[percnt]), gait disorder (42[percnt]), myoclonus (36[percnt]) and dystonia (35[percnt]). It was not uncommon for patients to present with a combination of symptoms, either in succession (morphing from one symptom to the other), alternating between symptoms, or occurring simultaneously. Interestingly, the most common associated feature was having a family member with a neurologic disorder, occurring in 58[percnt] of patients. Not all neurologic ...
Source: Neurology - Category: Neurology Authors: Tags: Movement Disorders: Miscellaneous Source Type: research