Clinical differences between patients with psychogenic nonepileptic seizures and functional motor disorder

Huepe-Artigas, Daniela; Carter, Olivia; Morsy, Shimaa K.; Kanaan, Richard A A

doi:10.1016/j.yebeh.2020.107577

Cited by 6 publications

(6 citation statements)

References 25 publications

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“…18 Huepe-Artigas et al found mood and anxiety disorders in approximately 80% of FS and FMD cases, a number very close to that found in our sample, which also reinforces the consistency of clinical characteristics between FS and FMD. 23 It is also important to highlight that the parity between among the results obtained and the data present in the current literature reinforce a cross-cultural character of the FND, since the cited studies present data from countries from continents such as North America, Europe, Asia, Oceania and Africa, while our study was carried out in a South American country. 7,18,23 We also verify that both groups show strong similarity in the use of several classes of psychiatric medications, such as in the use of antidepressants, anxiolytics, mood stabilizers and antipsychotics, demonstrating yet another point of overlap between these two populations.…”

Section: Discussionsupporting

confidence: 61%

“…23 It is also important to highlight that the parity between among the results obtained and the data present in the current literature reinforce a cross-cultural character of the FND, since the cited studies present data from countries from continents such as North America, Europe, Asia, Oceania and Africa, while our study was carried out in a South American country. 7,18,23 We also verify that both groups show strong similarity in the use of several classes of psychiatric medications, such as in the use of antidepressants, anxiolytics, mood stabilizers and antipsychotics, demonstrating yet another point of overlap between these two populations. These findings are unprecedented, as until now, no research had pointed out the pharmacotherapeutic similarity between the two groups.…”

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

“…It is also important to highlight that the parity between among the results obtained and the data present in the current literature reinforce a cross-cultural character of the FND, since the cited studies present data from countries from continents such as North America, Europe, Asia, Oceania and Africa, while our study was carried out in a South American country. 7 , 18 , 23 …”

Section: Discussionmentioning

confidence: 99%

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Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Pasquale¹,

Teive²,

Heyde³

et al. 2022

NDT

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Introduction Functional neurological disorders (FND) are conditions that cause to alterations in nervous system functions. They are disabling and impair the quality of life of patients but that are potentially reversible provided they have specific management. Functional seizures (FS) and functional movement disorder (FMD) are among the most common subtypes. Studies suggest a strong overlap between FS and FMD; however, there are still no cross-sectional studies that compare the management between these two conditions. Thus, our focus was to carry out a research that compares how these two subtypes of FND are being managed, in addition to assessing rates of understanding and acceptance of a diagnosis of FND. Methods It is a cross-sectional study with data collected from medical records and interviews with two patients’ groups (FS and FMD) treated from a FND clinic of the public health system of Brazil. Results From 105 medical records of patients with FND analyzed, 60 participants were eligible and agreed to participate in this research, being FS (n = 31) and FMD (n = 29). Statistically significant differences (p < 0.05) were found in the use of antiseizure (FS > FMD), opioids (FMD > FS), multi-professional follow-up (FMD > FS) and rates of understanding and acceptance of an FND diagnosis (FMD > FS). Similarities were found in sociodemographic profiles, medical follow-up, psychiatric comorbidities and use of antidepressants, anxiolytics, antipsychotics and mood stabilizers between two conditions. Conclusion More similarities than differences in management were found between FS and FMD. Similarities may be related to overlaps in sociodemographic and clinical characteristics between the two groups. Differences may be related to specific issues of each patient and condition. Regardless of the group, patients who perform psychotherapeutic follow-up have higher rates of understanding and acceptance of an FND diagnosis.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Pasquale¹,

Teive²,

Heyde³

et al. 2022

NDT

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“…This comparison also raises the possibility that, despite shared predisposing and precipitating factors in FMD and functional seizures, there may be important differences. Women may experience disproportionate trauma or adverse life events at younger ages than men, predisposing them to dissociation and developing functional seizures earlier in life, whereas physical injury or illness that may precipitate FMD24 may be more skewed towards older age groups 25…”

Section: Discussionmentioning

confidence: 99%

Functional movement disorder gender, age and phenotype study: a systematic review and individual patient meta-analysis of 4905 cases

Lidstone

Costa-Parke

Robinson

et al. 2022

J Neurol Neurosurg Psychiatry

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Functional movement disorder (FMD) is a common manifestation of functional neurological disorder presenting with diverse phenotypes such as tremor, weakness and gait disorder. Our current understanding of the basic epidemiological features of this condition is unclear. We aimed to describe and examine the relationship between age at onset, phenotype and gender in FMD in a large meta-analysis of published and unpublished individual patient cases. An electronic search of PubMed was conducted for studies from 1968 to 2019 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Individual patient data were collected through a research network. We described the distribution of age of onset and how this varied by gender and motor phenotype. A one-stage meta-analysis was performed using multilevel mixed-effects linear regression, including random intercepts for country and data source. A total of 4905 individual cases were analysed (72.6% woman). The mean age at onset was 39.6 years (SD 16.1). Women had a significantly earlier age of onset than men (39.1 years vs 41.0 years). Mixed FMD (23.1%), tremor (21.6%) and weakness (18.1%) were the most common phenotypes. Compared with tremor (40.7 years), the mean ages at onset of dystonia (34.5 years) and weakness (36.4 years) were significantly younger, while gait disorders (43.2 years) had a significantly later age at onset. The interaction between gender and phenotype was not significant. FMD peaks in midlife with varying effects of gender on age at onset and phenotype. The data gives some support to ‘lumping’ FMD as a unitary disorder but also highlights the value in ‘splitting’ into individual phenotypes where relevant.

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Updates in Functional Movement Disorders: from Pathophysiology to Treatment Advances

Kola

LaFaver

2022

Curr Neurol Neurosci Rep

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Purpose of Review This review discusses advances in functional movement disorders (FMD) over the past 3 years, with a focus on risk factors, diagnosis, pathophysiology, neuroimaging studies, and treatment. Recent Findings The past decade has brought a revived interest in functional movement disorders, with a growing number of studies exploring pathophysiological mechanisms. Here, we review recent studies demonstrating changes in attention, emotional and sensorimotor function in FMD. Through international collaborative efforts, progress has been made in defining biomarkers and outcome measures, an important prerequisite towards standardization of diagnosis and reporting of outcomes in clinical trials. Of particular interest are neuroimaging studies demonstrating functional and structural changes in motor and emotional brain circuits, deepening our understanding of FMD as a neurocircuit disorder and potentially paving the way towards new treatments. Currently available treatment modalities have shown successful outcomes via outpatient, inpatient, and virtual delivery. Summary The last 3 years have seen tremendous efforts to better understand, diagnose, and treat FMD. The disease model has been broadened to include a biopsychosocial formulation, and insights on the pathophysiology on FMD are informing treatment efforts. Several international multidisciplinary research collaborations are underway to define biomarkers and best outcome measures, highlighting the path towards improved standardization of future treatment trials. Additionally, the rise of telemedicine during the COVID-19 pandemic has reduced geographic barriers and paved the way for virtual therapy sessions and self-guided programs. Supplementary Information The online version contains supplementary material available at 10.1007/s11910-022-01192-9.

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Clinical differences between patients with psychogenic nonepileptic seizures and functional motor disorder

Cited by 6 publications

References 25 publications

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Management of Functional Seizures and Functional Movement Disorder: A Cross-Sectional Comparative Study

Functional movement disorder gender, age and phenotype study: a systematic review and individual patient meta-analysis of 4905 cases

Updates in Functional Movement Disorders: from Pathophysiology to Treatment Advances

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