Journal of Movement Disorders

Original Article

Psychodynamic Psychotherapy for Functional (Psychogenic) Movement Disorders: Vibhash D. Sharma, Randi Jones, Stewart A. Factor; J Mov Disord. 2017;10(1):40-44. Published online December 27, 2016; DOI: https://doi.org/10.14802/jmd.16038

12,326 View
189 Download
12 Web of Science
12 Crossref

Objective
As the literature for the treatment of functional (psychogenic) movement disorders (FMD) is sparse, we assessed clinical outcomes in patients with FMD who underwent treatment with psychodynamic psychotherapy (PDP).
Methods
A retrospective analysis of the data of patients with FMD who were referred for PDP from 2008−2014 at Emory University Medical Center was performed.
Results
Thirty patients were included, mean age at presentation was 50 years (SD 13.9) and majority were female (27/30). Most common movement disorder was involuntary shaking/jerky movements (50%) and tremor (43%). Mean duration of symptoms was 3.2 years and mean number of PDP visits was 4.9. PDP lead to good outcomes in 10, modest in 8, and poor in 9. Three patients lost to follow up. Mean duration of symptoms between two groups (good vs. poor) was not statistically significant (p = 0.11), mean number of PDP visits showed a trend towards significance (p = 0.053). In all cases of good outcomes precipitants of the movement disorder were identified and a majority (60%) was receptive of the diagnosis and had good insight.
Conclusion
PDP lead to improvement in 60% of the patients which is encouraging as the treatment is challenging. This study supports heterogeneous causes of FMD including varied roles of past/recent events and demonstrates importance of psychological approaches such as PDP. Treatment with PDP should be considered in some patients with FMD but predicting who will respond remains a challenge. Further long term prospective studies with large sample size and placebo control are needed.

Citations

Citations to this article as recorded by

Functional Tic‐Like Behaviors: A Common Comorbidity in Patients with Tourette Syndrome
Kirsten R. Müller‐Vahl, Anna Pisarenko, Carolin Fremer, Martina Haas, Ewgeni Jakubovski, Natalia Szejko
Movement Disorders Clinical Practice.2024; 11(3): 227. CrossRef
Neuropsychiatric Treatment Approaches for Functional Neurological Disorder: A How to Guide
Sara A. Finkelstein, Caitlin Adams, Margaret Tuttle, Aneeta Saxena, David L. Perez
Seminars in Neurology.2022; 42(02): 204. CrossRef
Functional tremor
Petra Schwingenschuh, Alberto J. Espay
Journal of the Neurological Sciences.2022; 435: 120208. CrossRef
Psychological interventions for treating functional motor symptoms: A systematic scoping review of the literature
Erin M. Beal, Peter Coates, Cara Pelser
Clinical Psychology Review.2022; 94: 102146. CrossRef
Living with functional movement disorders: a tale of three battles. An interpretative phenomenological analysis
Sylwia Bazydlo, Fiona J. R. Eccles
Psychology & Health.2022; : 1. CrossRef
Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study
Bruno Gabriel Dal Pasquale, Hélio Afonso Ghizoni Teive, Marcelo Daudt von der Heyde, Luana Francine Anad Dal Pasquale
Neuropsychiatric Disease and Treatment.2022; Volume 18: 2121. CrossRef
Efficacy of a 5-day, intensive, multidisciplinary, outpatient physical and occupational therapy protocol in the treatment of functional movement disorders: A retrospective study
Megan Reid, Steven D. Mitchell, Katharine M. Mitchell, Christos Sidiropoulos
Journal of the Neurological Sciences.2022; 443: 120461. CrossRef
Diagnosis and therapy of functional tremor a systematic review illustrated by a case report
Michael Bartl, Rebekka Kewitsch, Mark Hallett, Martin Tegenthoff, Walter Paulus
Neurological Research and Practice.2020;[Epub] CrossRef
Speech, language and swallowing impairments in functional neurological disorder: a scoping review
Caroline Barnett, Jean Armes, Christina Smith
International Journal of Language & Communication Disorders.2019; 54(3): 309. CrossRef
Functional movement disorders in neurogeriatric inpatients
Sara Mätzold, Johanna Geritz, Kirsten E. Zeuner, Daniela Berg, Steffen Paschen, Johanne Hieke, Simone Sablowsky, Christian Ortlieb, Philipp Bergmann, Werner Hofmann, Alberto J. Espay, Walter Maetzler
Zeitschrift für Gerontologie und Geriatrie.2019; 52(4): 324. CrossRef
Psychogenic (Functional) Movement Disorders
Mary Ann Thenganatt, Joseph Jankovic
CONTINUUM: Lifelong Learning in Neurology.2019; 25(4): 1121. CrossRef
Disentangling Stigma from Functional Neurological Disorders: Conference Report and Roadmap for the Future
Karen S. Rommelfanger, Stewart A. Factor, Suzette LaRoche, Phyllis Rosen, Raymond Young, Mark H. Rapaport
Frontiers in Neurology.2017;[Epub] CrossRef

Case Reports

A Case of Intractable Psychogenic Essential Palatal Tremor: Eun Joo Chung, Hyun Jung, Sang Jin Kim; J Mov Disord. 2012;5(2):55-56.; DOI: https://doi.org/10.14802/jmd.12013

11,462 View
75 Download
1 Crossref

Abstract PDF

Essential palatal tremor (EPT) is a rare disorder which shows rhythmic involuntary movement of the muscles of soft palate, especially tensor veli palatini muscle. EPT is classified by two subtypes, which is primary and secondary EPT. Secondary EPT includes psychogenic type. We describe a case of intractable psychogenic EPT.

Citations

Citations to this article as recorded by

Botulinum toxin treatment for essential palatal tremors presenting with nasal clicks instead of pulsatile tinnitus: a case report
Yufeng Ye, Shiyu Liao, Baozhen Luo, Liyan Ni
Head & Face Medicine.2016;[Epub] CrossRef

Attention in Parkinson’s Disease Mimicking Suggestion in Psychogenic Movement Disorder: Jong Sam Baik; J Mov Disord. 2012;5(2):53-54.; DOI: https://doi.org/10.14802/jmd.12012

13,465 View
59 Download
3 Crossref

Abstract PDF

The various reported psychogenic movement disorders (PMDs) include tremor, dystonia, myoclonus, gait disorder, Parkinsonism, tics, and chorea. Although it is not easy to diagnose PMDs, several features such as distractibility, entrainment, suggestion and placebo trial are quite helpful to diagnose. Especially, distractibility or suggestion is a good tool to do in outpatient clinic easily. We describe a patient with parkinsonian features which were improved by internal suggestion to focusing attention. Initially, we suspected her diagnosis as PMDs; however she was confirmed with organic Parkinson’s disease later.

Citations

Citations to this article as recorded by

Functional neurological disorder and placebo and nocebo effects: shared mechanisms
Mirta Fiorio, Miriam Braga, Angela Marotta, Bernardo Villa-Sánchez, Mark J. Edwards, Michele Tinazzi, Diletta Barbiani
Nature Reviews Neurology.2022; 18(10): 624. CrossRef
Functional Motor Symptoms in Parkinson’s Disease and Functional Parkinsonism: A Systematic Review
Marine Ambar Akkaoui, Pierre A. Geoffroy, Emmanuel Roze, Bertrand Degos, Béatrice Garcin
The Journal of Neuropsychiatry and Clinical Neurosciences.2020; 32(1): 4. CrossRef
Somatization in Parkinson's Disease: A systematic review
Danilo Carrozzino, Per Bech, Chiara Patierno, Marco Onofrj, Bo Mohr Morberg, Astrid Thomas, Laura Bonanni, Mario Fulcheri
Progress in Neuro-Psychopharmacology and Biological Psychiatry.2017; 78: 18. CrossRef

Psychogenic Balance Disorders: Is It a New Entity of Psychogenic Movement Disorders?: Jong Sam Baik, Myung Sik Lee; J Mov Disord. 2012;5(1):24-27.; DOI: https://doi.org/10.14802/jmd.12007

16,261 View
99 Download
2 Crossref

Abstract PDF

The various reported psychogenic dyskinesias include tremor, dystonia, myoclonus, gait disorder, Parkinsonism, tics, and chorea. It is not easy to diagnose psychogenic movement disorders, especially in patients with underlying organic disease. We describe three patients with balance and/or posture abnormalities that occur when they stand up, start to move, or halt from walking, although their gaits are normal. One had an underlying unilateral frontal lobe lesion. All patients improved dramatically after receiving a placebo-injection or medication. These abnormal features differ from the previously reported features of astasia without abasia and of psychogenic gait disorders, including recumbent gait. We describe and discuss the patients’ unique clinical characteristics.

Citations

Citations to this article as recorded by

Somatization in Parkinson's Disease: A systematic review
Danilo Carrozzino, Per Bech, Chiara Patierno, Marco Onofrj, Bo Mohr Morberg, Astrid Thomas, Laura Bonanni, Mario Fulcheri
Progress in Neuro-Psychopharmacology and Biological Psychiatry.2017; 78: 18. CrossRef
Functional movement disorders
Anita Barbey, Selma Aybek
Current Opinion in Neurology.2017; 30(4): 427. CrossRef

Review Article

Electrophysiologic Evaluation of Psychogenic Movement Disorders: Pramod Kumar Pal; J Mov Disord. 2011;4(1):21-32.; DOI: https://doi.org/10.14802/jmd.11004

31,016 View
348 Download
8 Crossref

Abstract PDF

Psychogenic movement disorders (PMD) are a group of disorders which are in the border zone between neurology and psychiatry. All necessary laboratory investigations should be done to rule out an underlying organic disorder. While clinical acumen of a trained movement disorder specialist may be sufficient to diagnose most PMD, there are clinical situations where electrophysiological tests are required either to rule out an organic movement disorder or even diagnose a PMD. Current electrophysiological test are most useful for tremor, followed by jerks and least for spasms or dystonia. Commonly used electrophysiologic tests include multichannel surface electromyography (EMG), accelerometry, electroencephalography time locked with EMG, premovement potential (Bereitschaftspotential), and somatosensory evoked potentials. Psychogenic tremor is a low frequency tremor with variable frequency and duration of EMG bursts, entrainable, has a high coherence with voluntary movements, and presence of coactivation sign. Patients with psychogenic jerks have well organized triphasic pattern of activation of agonist and antagonist muscles. The jerks are associated with EMG bursts of long duration (usually > 70 ms), long and variable latencies in stimulus induced jerks, absence of craniocaudal pattern of muscle recruitment in apparent startle response, and often a Breitschaftspotential (premovement potential) precedes the jerk. Electrophysiological characterization of psychogenic dystonia is difficult and the tests are usually performed to rule out organic dystonia with characteristic findings. Finally, caution should be exerted in interpreting the electrophysiological tests as both false positive and false negative diagnosis of PMD may still occur.

Citations

Citations to this article as recorded by

Investigation of Phase Shifts Using AUC Diagrams: Application to Differential Diagnosis of Parkinson’s Disease and Essential Tremor
Olga S. Sushkova, Alexei A. Morozov, Ivan A. Kershner, Margarita N. Khokhlova, Alexandra V. Gabova, Alexei V. Karabanov, Larisa A. Chigaleichick, Sergei N. Illarioshkin
Sensors.2023; 23(3): 1531. CrossRef
Electrophysiology in Functional Movement Disorders: An Update
Nitish Kamble, Pramod Kumar Pal
Tremor and Other Hyperkinetic Movements.2023;[Epub] CrossRef
Video electroencephalogram combined with electromyography in the diagnosis of hyperkinetic movement disorders with an unknown cause
Jianhua Chen, Xiangqin Zhou, Qiang Lu, Liri Jin, Yan Huang
Neurological Sciences.2021; 42(9): 3801. CrossRef
Suggestibility as a valuable criterion for laboratory-supported definite functional movement disorders
Gerard Saranza, Daniel Vargas-Mendez, Anthony E. Lang, Robert Chen
Clinical Neurophysiology Practice.2021; 6: 103. CrossRef
Principles of Electrophysiological Assessments for Movement Disorders
Kai-Hsiang Stanley Chen, Robert Chen
Journal of Movement Disorders.2020; 13(1): 27. CrossRef
A case of abdominal functional myoclonus analyzed by movement related cortical potentials
Ryosuke Urabe, Masaya Kubota
Brain and Development.2020; 42(9): 700. CrossRef
Focal localized enhanced physiological tremor after physical insult
Sang-Won Yoo, Myungah Lee, Joong-Seok Kim, Kwang-Soo Lee
Neurological Sciences.2019; 40(12): 2641. CrossRef
Sleep-Related Movement Disorders: Hypnic Jerks
Robyn Whitney, Shelly K. Weiss
Current Sleep Medicine Reports.2018; 4(1): 19. CrossRef

Original Article

Psychogenic Gait Disorders after Mass School Vaccination of Influenza A: Jung Ho Ryu, Jong Sam Baik; J Mov Disord. 2010;3(1):15-17.; DOI: https://doi.org/10.14802/jmd.10004

7,801 View
34 Download
5 Crossref

Abstract PDF

Background and Purpose

Psychogenic movement disorders (PMD) after war or mass vaccination was reported and well known disease entity already. However, we have seldom been met those patients because we don’t have any chance to experience of those events. Recently, influenza A (H1N1) spreads around world, and many countries have a program of mass vaccination of H1N1. Although PMD in adult is well characterized, childhood-onset PMD has not been extensively studied.

Case Reports

We present four children of psychogenic gait disorders (PGDs) after mass school vaccination of H1N1. They had fluctuating weakness and their prognosis was good. We confirmed all patients as PGD by placebo.

Conclusions

Our four cases have two common characteristics. One is that all were young and their prognosis was good. And the other is that all were induced their abnormal gait symptoms after mass school vaccination. We observed that mass PMD has a different characteristics comparing to personal PMD, and PMD in children is differ from adult onset PMD.

Citations

Citations to this article as recorded by

Diagnosing Common Movement Disorders in Children
Jennifer A. O’Malley
CONTINUUM: Lifelong Learning in Neurology.2022; 28(5): 1476. CrossRef
Immunization stress-related responses: Implications for vaccination hesitancy and vaccination processes during the COVID-19 pandemic
Steven Taylor, Gordon J.G. Asmundson
Journal of Anxiety Disorders.2021; 84: 102489. CrossRef
Functional Neurological Disorder after Vaccination: A Balanced Approach Informed by History
Stefanie C Linden, Alan J Carson, Simon Wessely
Journal of the Royal College of Physicians of Edinburgh.2021; 51(4): 330. CrossRef
Psychogenic Gait Disorder Complicating Recovery after Concussion: A Case Series
Scott I. Otallah
Pediatric Neurology.2020;[Epub] CrossRef
Psychogenic movement disorders in children and adolescents: an update
Susan R. Harris
European Journal of Pediatrics.2019; 178(4): 581. CrossRef

First
Prev
Page of 1
Next
Last

Search