Cross-cultural influences on psychogenic movement disorders – A comparative review with a Brazilian series of 83 cases

Munhoz, Renato P.; Zavala, Jorge A.; Becker, Nílson; Teive, Hélio Afonso Ghizoni

doi:10.1016/j.clineuro.2010.10.004

Cited by 19 publications

(20 citation statements)

References 17 publications

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“…32 These disorders can develop at any age, [29][30][31][32] though a higher occurrence is consistently reported between age 20 and 45 for both PNES and PMD. 2,31 Moreover, no demographic and clinical differences with regards to ethnicity have been found between Spanish and North American populations 33 and when comparing patients from Latin America with other published series from North America and Turkey, 34 supporting the transcultural aspect of these disorders. 34 The assessment of other demographic and social features, including education level, employment, and marital status, also did not reveal any difference between patients with PNES and PMD.…”

Section: Epidemiology and Demographicsmentioning

confidence: 95%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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Purpose of review: Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. Recent findings:Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. Summary: Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients. Neurol Clin Pract 2016;6:138-149 N eurologic symptoms due to a functional or psychogenic cause are common in clinical practice, accounting for up to 16% of patients presenting to neurology outpatient clinics, depending on the clinical definitions and methodology used for case ascertainment.1,2 The yearly costs of patients with medically unexplained symptoms in the United States have been estimated at approximately $256 billion per year.3 Despite their prevalence and associated economic and social burden, appropriate treatments for these disorders are an unmet need. This may reflect the absence of research interest and lack of discourse between neurology and psychiatry regarding these patients. Notably, although approximately 50% of the patients with somatoform disorders are identified by neurologists at the time of first contact, only 1.5% are referred to a psychiatrist or a psychologist.

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Section: Epidemiology and Demographicsmentioning

confidence: 95%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…PMD Most of the information used to delineate the currently available diagnostic criteria for PMD come from case series. The three most significant of these series are those described by Lang 33 , including the case series of PMD evaluated by (Table 4), tremor was the most frequent PMD (55.6%) 30 . The second most common PMD semiology was pure dystonia (33.3%), agreeing with data in the medical literature in which the frequency of this presentation ranges from 15% to 53% 30,31 .…”

Section: Diagnosis Of Pmdmentioning

confidence: 99%

“…More recent epidemiological data show that PMD represents 2% to 3% of all cases seen in movement disorders clinics and occur more commonly in women (ratio of men to women about 1:5) between 37 and 50 years of age 30,31,32,33 . Like PNES, comorbidities are common in PMD.…”

Section: Psychogenic Movement Disordersmentioning

confidence: 99%

“…Historically, Charcot was known for his great interest in psychogenic cases and for paying special attention in its definition and treatment 2 . Charcot considered that besides women, men employed in labor, effeminate men and children were prone to the development of hysterical neurological deficits, including PNES (then referred to as hysteroepilepsy) and PMD 2,29,30 .…”

Section: Psychogenic Movement Disordersmentioning

confidence: 99%

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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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“…The mean age at onset described in several case series on these disorders ranges between 37 years and 50 years and women are predominantly affected with a range of 61-87% Factor et al, 1995). There are no data on racial distribution in the published research, however a trans-cultural comparison between patients with these disorders in the USA, in Spain, and in Brazil showed essentially similar demographic and clinical characteristics by ethnic origin Munhoz et al, 2010). Nearly 15% of patients with a psychogenic movement disorder have also an underlying organic movement disorder (Ranawaya el al., 1990).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 76%

Psychogenic Movement Disorders

Dallocchio¹

2011

Psychiatric Disorders - Trends and Developments

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Cross-cultural influences on psychogenic movement disorders – A comparative review with a Brazilian series of 83 cases

Cited by 19 publications

References 17 publications

Psychogenic nonepileptic seizures and movement disorders

Psychogenic nonepileptic seizures and movement disorders

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

Psychogenic Movement Disorders

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