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Psychogenic Movement Disorders

PMD


Presentation

  • The clinical presentation of psychogenic myoclonus is extremely rich and polymorphous and can mimic virtually all forms of cortical, subcortical or spinal myoclonus. Focal, multifocal, axial or generalized jerks can occur.[ncbi.nlm.nih.gov]
Asymptomatic
  • Here, 4 patients experienced sustained relief of blepharospasm following administration of subcutaneous saline solution, and one was witnessed asymptomatic when supposedly unobserved.[mdsabstracts.org]
Asterixis
  • Organic jerks In most types of jerks, the movement of the body part is associated with EMG activity of the corresponding muscle except in asterixis or negative myoclonus where the movement is associated with silence in muscle activity.[e-jmd.org]
Neglect
  • This review encompasses historical and epidemiological data, clinical aspects, diagnostic criteria, treatment and prognosis of these rather challenging and often neglected patients.[ncbi.nlm.nih.gov]
  • Psychogenic Movement Disorders: These are an often neglected category of movement disorders. These are caused by psychological factors, and hence they were earlier classified as functional or non-organic movement disorders.[icliniq.com]
Tremulousness
  • Clinical examination and prolonged observation usually help the examiner to identify the muscles which are “tremulous” and require to be studied.[e-jmd.org]

Treatment

  • Recent developments in our understanding of psychogenic movement disorders have not yet led to advances in treatment.[ncbi.nlm.nih.gov]

Prognosis

  • A shorter duration of symptoms and a co-existent treatable psychiatric disorder portend a better prognosis, whereas compensation and pending litigation are associated with a poorer prognosis.[ncbi.nlm.nih.gov]

Etiology

  • The term ''organic'' is used to mean ''not due to a psychogenic etiology'', and, thus the term '' non-organic '' refers to psychogenic etiology .[icliniq.com]
  • Subsequently, different etiologies of dystonia, tremor, myoclonus, and other movement disorders were recognized.[frontiersin.org]
  • Since that is rarely the case, even for a physical symptom that does have an organic etiology; the patient is often disappointed by the neurological examination results and may be reluctant to delve into the complicated unconscious conflicts that are[e-sciencecentral.org]
  • For the purpose of discussion in this review, the terms “psychogenic” or “pseudoneurologic” will be used to refer to neurologic symptoms for which a psychologic etiology is suspected.[aafp.org]
  • After several examinations, her neurological findings were found to be at variance with an organic etiology, and a psychiatrist evaluated her symptoms as being due to hysterical conversion.[ci.nii.ac.jp]

Epidemiology

  • This review encompasses historical and epidemiological data, clinical aspects, diagnostic criteria, treatment and prognosis of these rather challenging and often neglected patients.[ncbi.nlm.nih.gov]
  • Definition Abnormal movements occurring from psychiatric cause Epidemiology As many 4% of patients seen in a movement disorders center Women men Risk factors include trauma, surgery, stressful events Pathophysiology Unknown May be similar to conversion[wiki.uiowa.edu]
  • The next section of the book delineates the phenomenology (descriptions) of the movements as well as the epidemiology of the disorders. These chapters were written by specialists in movement disorders.[nejm.org]
  • Clinical Practice and Epidemiology in Mental Health : CP & EMH . 8 : 110–119. doi : 10.2174/1745017901208010110 . ISSN 1745-0179 . PMC 3480686 . PMID 23115576 . a b c Webster, Richard.[en.wikipedia.org]
Sex distribution
Age distribution

Pathophysiology

  • As with other functional disorders, a key issue is the absence of pathophysiological understanding. There has been an influential historical emphasis on causation by emotional trauma, which is not supported by epidemiological studies.[ncbi.nlm.nih.gov]

Prevention

  • Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management.[ncbi.nlm.nih.gov]
  • They are suppressible, meaning the patient may be able to prevent an oncoming tic from happening.[bcm.edu]
  • A fixed foot in plantar flexion and inversion prevents weight bearing, and forces the use of an assistive device (walker or wheelchair). A magnified view of the patient’s right foot is shown on the right. d . Swivel chair sign.[clinicalmovementdisorders.biomedcentral.com]
  • Early recognition and prompt intervention are needed to prevent social and academic disruptions, and hence a debilitating outcome.[pediatrics.imedpub.com]
  • For example, Sydenham’s chorea may be treated with oral or IV steroids as well as daily penicillin to prevent future streptococcal infections. Myoclonus Myoclonus is sometimes epileptic and sometimes a movement disorder.[childneurologyfoundation.org]

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