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JMD : Journal of Movement Disorders

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2 "psychogenic movement disorders"
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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
  • 11,193 View
  • 172 Download
  • 11 Citations
AbstractAbstract PDF
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  
  • 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
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
  • 28,890 View
  • 315 Download
  • 7 Citations
AbstractAbstract 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
  • 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

JMD : Journal of Movement Disorders