Abnormal Eye and Cranial Movements Triggered by Examination in People with Functional Neurological Disorder

Teodoro, Tiago; Cunha, Joana; Abreu, Luis; Yogarajah, Mahinda; Edwards, Mark J.

doi:10.1080/01658107.2018.1536998

Cited by 9 publications

(9 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We had 4 patients who had abnormal movements related to the eyes: one patient each of bilateral ptosis, blepharospasm, eyebrow dyskinesia, and bilateral 'painful' eyelid myoclonus. In a large series of 101 patients clinical examination triggered facial and eye movement disorders in 46% of patients, but, this phenomenon was not observed in any of our patients [15]. In the same vein, Stone et al in 2010 reported a case with recurrent episodes of right "pseudoptosis" with contraction of orbicularis oculis and oris which gave an impression of right facial weakness with unilateral photophobia in the right eye [14].…”

Section: Eyesmentioning

confidence: 48%

“…Depression and headache were also common in the series by Fasano et al [7]. Other organic clinical entities that were found to co-exist in 15 Certain limitations should be kept in mind before the interpretation of the results of our study. The major limitation was represented by its retrospective chart review design, which Video: Cranial functional movement disorder patients (cases 1-9): Abnormal movements, variability and distractibility are seen in different patients.…”

Section: Associated Illnessesmentioning

confidence: 53%

“…In a study of the 101 patients with functional abnormalities, Teodoro et al reported that effortful facial expression and other responses (e.g. frowning, grimacing, effortful breathing) in 26.7% of patients and/or excessive blinking in 38.6% of patients predominated, with at least one of them being present in 40.6% (41/101) patients [15].…”

Section: Summary Of the Cranial Functional Movement Disorders Cases Rmentioning

confidence: 99%

See 2 more Smart Citations

Cranial Functional Movement Disorders: A Case Series with Literature Review

Mishra

Pandey

2020

Tremor and Other Hyperkinetic Movements

View full text Add to dashboard Cite

Background: Cranial functional movement disorders (CFMDs) affect the face, eyes, jaw, tongue, and palate. Objectives: We aimed to examine our large series of functional movement disorders (FMDs) patients where the cranial muscles were involved to determine their phenomenology and other clinical features. Methods: This is a chart review of 26 patients who presented with CFMDs. Results: There were 16 (61.53%) females and 10 (38.46%) male patients. The mean ± [standard deviation (SD)] age at the presentation was 33.96 ± 16.94 (Range: 11-83) years. The duration of symptoms ranged from one day to 6 years (Mean ±SD: 402.03 ±534.97 days). According to the Fahn-Williams criteria, CFMDs were documented in 24 patients and clinically established in two patients. The facial [38.46% (10/26)] involvement was the most common in our CFMDs patients. Oromandibular [19.23% (5/26)], ocular [15.38% (4/26)], lingual [15.38% (4/26)], speech [15.38% (4/26)] and palatal [(3.85; 1/26)] involvement was also seen. 10 (38.46%) patients also had associated FMD in the extracranial regions. Precipitating factors were present in 84.61% (22/26) of the patients and associated illnesses were present in 42.30% (11/26) of the patients. At 3 months follow-up, 9 (34.61%) patients had improved, 13 (50%) had partial improvement and 4 (15.38%) had no improvement. Conclusions: There was a slight female preponderance in our patients. CFMDs are more likely to involve facial muscles. Associated medical conditions like neuropsychiatric disturbances and headaches are frequently present in CFMDs patients. Early clinical diagnosis will avoid unnecessary investigations and allow the patient to seek the right treatment.

show abstract

Section: Eyesmentioning

confidence: 48%

Section: Associated Illnessesmentioning

confidence: 53%

Section: Summary Of the Cranial Functional Movement Disorders Cases Rmentioning

confidence: 99%

See 1 more Smart Citation

Cranial Functional Movement Disorders: A Case Series with Literature Review

Mishra

Pandey

2020

Tremor and Other Hyperkinetic Movements

View full text Add to dashboard Cite

show abstract

“…Previous studies have also reported the presence of abnormal eye and cranial movements provoked by neurological examination (movement) [ 14 , 15 ] and functional seizures induced by photic stimulation, saline injections and hypnosis [ 5 ]. Such triggers have been also described in other neurological diseases like migraine [ 16 ], epilepsy [ 17 ], and Parkinson’s disease [ 18 ], but they have never been extensively investigated and characterized in FMD.…”

Section: Introductionmentioning

confidence: 99%

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

et al. 2022

View full text Add to dashboard Cite

Background and objective People with functional motor disorder (FMD) report triggers—sensory or motor-induced stimuli that exacerbate or initiate paroxysmal occurrences of their movement disorder. These are a distinct phenomenon from precipitating factors occurring at the initial onset of the disorder. We aimed to assess triggers in FMD and understand their relevance to paroxysmal variability often seen in FMD. Methods We enrolled consecutive outpatients with a definite diagnosis of FMD. Each patient underwent a detailed clinical evaluation also including the presence of trigger factors and video-recordings both during neurological examination and physiotherapy treatment. Patients were classified as having “triggers” (T-FMD) or “not having triggers” (NoT-FMD) as well as “paroxysmal” compared to “persistent with paroxysmal variability”. Results The study sample was 100 patients (82% female) with FMD; the mean age at onset was 41 years. Triggers were observed in 88% of patients and in 65 of these the FMD was pure paroxysmal. The most common triggers were movement or physical exercise, followed by emotional, visual, touch, and auditory stimuli; 39 (44%) were isolated and 49 (56%) were combined triggers. Among the T-FMD patients, FMD were paroxysmal in 74% (n = 65) and persistent with paroxysmal variability in 26% (n = 23). The T-FMD patients were younger (p = 0.016) and had a gait disorder (p = 0.035) more frequently than the NoT-FMD patients. Discussion Triggers are frequent in FMD and may have diverse overlapping clinical presentations. In this sample, FMD was most often paroxysmal, suggesting the value of noting triggers as clinical clues in the diagnosis and rehabilitation of FMD.

show abstract

“…For the review of positive signs, we summarized in table 2 and table 3 those which had some form of validation (controlled designs to test for specificity and sensitivity or data on inter-rater reliability). To this end, we selected 22 studies45464748495051525354555657585960616263919293 reporting on 37 bedside clinical tests or groups of tests for motor FND (functional weakness and functional movement disorder) as well as 27 studies646566676869707172737475767778798081828384858687909495 reporting on 23 bedside clinical tests or group of tests for seizure type FND. In addition, we also discuss important case series or reviews that highlight relevant bedside clinical tests.…”

Section: Incidence and Prevalence Of Fndmentioning

confidence: 99%

Diagnosis and management of functional neurological disorder

Aybek

Perez

2022

BMJ

122

107

View full text Add to dashboard Cite

Functional neurological disorder (FND), previously regarded as a diagnosis of exclusion, is now a rule-in diagnosis with available treatments. This represents a major step toward destigmatizing the disorder, which was often doubted and deemed untreatable. FND is prevalent, generally affecting young and middle aged adults, and can cause severe disability in some individuals. An early diagnosis, with subsequent access to evidence based rehabilitative and/or psychological treatments, can promote recovery—albeit not all patients respond to currently available treatments. This review presents the latest advances in the use of validated rule-in examination signs to guide diagnosis, and the range of therapeutic approaches available to care for patients with FND. The article focuses on the two most frequently identified subtypes of FND: motor (weakness and/or movement disorders) and seizure type symptoms. Twenty two studies on motor and 27 studies on seizure type symptoms report high specificities of clinical signs (64-100%), and individual signs are reviewed. Rehabilitative interventions (physical and occupational therapy) are treatments of choice for functional motor symptoms, while psychotherapy is an emerging evidence based treatment across FND subtypes. The literature to date highlights heterogeneity in responses to treatment, underscoring that more research is needed to individualize treatments and develop novel interventions.

show abstract

Abnormal Eye and Cranial Movements Triggered by Examination in People with Functional Neurological Disorder

Cited by 9 publications

References 8 publications

Cranial Functional Movement Disorders: A Case Series with Literature Review

Cranial Functional Movement Disorders: A Case Series with Literature Review

Triggers in functional motor disorder: a clinical feature distinct from precipitating factors

Diagnosis and management of functional neurological disorder

Contact Info

Product

Resources

About