Clinical characteristics of 49 patients with psychogenic movement disorders in a tertiary clinic in Turkey

Ertan, Sibel; Uludüz, Derya; Özekmekçi, Sibel; Kızıltan, Güneş; Ertan, Turan; Yalçınkaya, Cengiz; Özkara, Çiğdem

doi:10.1002/mds.22114

Cited by 45 publications

(37 citation statements)

References 12 publications

(40 reference statements)

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“…Recent reports have highlighted the occurrence of PMDs in children; these are largely similar to those seen in adults, although some differences may exist including possibly more frequent involvement of the dominant limb19 and less frequent coexisting organic neurological disease19 and underlying psychiatric disease 20. PMDs seen in other cultures, including Turkey21 and Spain,22 are largely similar to those found in North America. There is an extensive literature highlighting the considerable disability experienced by patients with conversion disorders, but little data exists directly related to PMDs.…”

Section: Advances In the Past 25 Yearsmentioning

confidence: 78%

Psychogenic movement disorders: Past developments, current status, and future directions

Lang

Voon

2011

Movement Disorders

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As the field of movement disorders has developed and matured over the past 25 years, psychogenic movement disorders have become increasingly recognized in subspecialty clinics. The diagnosis can be challenging and should be based on positive features rather than a purely exclusionary approach. The clinical phenotype can be quite varied, although certain categories of abnormal movement are more common than others. Electrophysiological studies may be particularly useful in establishing the diagnosis, especially with respect to tremor and myoclonus, and an argument can be made for adding a "laboratory-supported definite" category to earlier classification schemes. The diagnosis of psychogenic dystonia remains a major challenge, although there are some recent promising developments with respect to the evaluation of cortical plasticity that require further study. The pathogenesis of psychogenic movement disorders is poorly understood; insights may be provided from the study of other neurological conversion disorders such as psychogenic hemiparesis. Psychogenic movement disorders typically result in considerable disability and negatively impact quality of life to the same or greater extent than do many organic movement disorders. Treatment is extremely challenging, and many patients experience chronic disability despite various therapeutic interventions. Given the personal and societal impact of these problems, further advances in our understanding of their pathogenesis and the subsequent development of effective therapies are sorely needed.

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Section: Advances In the Past 25 Yearsmentioning

confidence: 78%

Psychogenic movement disorders: Past developments, current status, and future directions

Lang

Voon

2011

Movement Disorders

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“…In contrast, Thomas et al, evaluated 228 patients with PMD with a mean follow-up of 3.4 years (6 months to 12 years), and concluded that symptoms improved in 56.6% of patients, worsened in 22.1% and remained the same in 21.3% 42 . Ertan et al studied 49 patients with PMD in a tertiary clinic in Turkey and concluded that the response to treatment was poor, with a high rate of drop out of these patients in the follow-up 44 .…”

Section: Prognosis Of Pmdmentioning

confidence: 99%

Psychogenic nonepileptic seizures and psychogenic movement disorders: two sides of the same coin?

Paola

Marchetti

Teive

et al. 2014

Arq. Neuro-Psiquiatr.

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Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are commonly seen in Neurology practice and are categorized in the DSM-5 as functional neurological disorders/conversion disorders. This review encompasses historical and epidemiological data, clinical aspects, diagnostic criteria, treatment and prognosis of these rather challenging and often neglected patients. As a group they have puzzled generations of neurologists and psychiatrists and in some ways continue to do so, perhaps embodying and justifying the ultimate and necessary link between these specialties.Keywords: psychogenic nonepileptic seizures, psychogenic movement disorders, conversion disorder, hysteria. RESUMOCrises não-epilépticas psicogênicas (CNEP) e distúrbios do movimento psicogênicos (DMP) são comuns na prática e na atualidade são melhor categorizados no DSM-V como distúrbios neurológicos funcionais/desordens de conversão. Esta revisão enfatiza os principais dados históricos, epidemiológicos, clínicos, critérios diagnósticos, tratamento e o prognóstico destes pacientes, frequentemente negligenciados e desafiadores, os quais, como um grupo, tem intrigado gerações de neurologistas e psiquiatras, caracterizando, de forma justificada o elo definitivo entre estas especialidades.Palavras-chave: crises não-epilépticas psicogênicas, distúrbios do movimento psicogênicos, distúrbio conversivo, histeria.In the medical sciences, a diagnosis is established when a level of certainty regarding the nature of a condition is achieved. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) share a slightly less linear diagnostic route. Historically, making a conversion diagnosis required ruling out the originally considered medical diagnosis, i.e., it is neither epilepsy, nor a neurogenic movement disorder. Only then a non-neurologic (in the sense of not resulting from epileptogenic or known motor circuitry imbalance) condition is suspected and raised to the level of diagnosis 1 . This kind of diagnosis has intrigued generations of physicians and spared no culture, gender or age. A diversity of symptoms, including motor, sensory, cognitive, and/or behavior symptoms are present in these presentations. Patients with PNES or PMD frequently are misdiagnosed as having their initial suspected neurological diseases, and ultimately pose a diagnostic and treatment challenge to many clinicians. Interestingly, it was perhaps this varied presentation that has captured the attention of many professionals through the centuries and lead to the construction and recognition of a very particular diagnosis. Two rather advanced historic civilizations, Egyptians first, and then the Greeks, posited that a displaced hystera (womb), and the consequent suffocation that it produced, was the source of choking, mutism, paralysis and fainting 1 . Hysteria, a natural development on this concept, was claimed as an explanation for similar phenomena in women and reached almost epidemic proportions in the late 19 th century. By th...

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“…In other series, the frequency of PSVDs in patients with PMDs varies between 3.6 and 28 % ( Table 2) [9][10][11][12][13][14][15][16][17]. Although abnormal speech has been proposed in a rating scale for PMDs, highlighting the importance of this manifestation, many case series of PMDs do not mention the presence of speech or voice disorders and the descriptions often lack detail.…”

Section: Discussionmentioning

confidence: 92%

Speech and voice disorders in patients with psychogenic movement disorders

Baizabal‐Carvallo

Jankovic

2015

J Neurol

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Psychogenic speech and voice disorders (PSVDs) may occur in isolation but more typically are encountered in the setting of other psychogenic disorders. We aimed to characterize the phenomenology, frequency, and correlates of PSVDs in a cohort of patients with psychogenic movement disorders (PMDs). We studied 182 consecutive patients with PMDs, 30 of whom (16.5 %) also exhibited PSVD. Stuttering was the most common speech abnormality (n = 16, 53.3 %), followed by speech arrests (n = 4, 13.3 %), foreign accent syndrome (n = 2, 6.6 %), hypophonia (n = 2, 6.6 %), and dysphonia (n = 2, 6.6 %). Four patients (13.2 %) had more complex presentations with different combinations of these patterns. No differences in gender, age at onset, and distribution of PMDs were observed between patients with and without PSVD. PSVDs are relatively frequent in patients with PMDs and are manifested by a wide variety of abnormal speech and voice phenomena, with stuttering being the most common presentation. Speech therapy and insight-oriented counseling may be helpful to some patients.

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Clinical characteristics of 49 patients with psychogenic movement disorders in a tertiary clinic in Turkey

Cited by 45 publications

References 12 publications

Psychogenic movement disorders: Past developments, current status, and future directions

Psychogenic movement disorders: Past developments, current status, and future directions

Psychogenic nonepileptic seizures and psychogenic movement disorders: two sides of the same coin?

Speech and voice disorders in patients with psychogenic movement disorders

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