Disease modeling in functional movement disorders

Pellicciari, Roberta; Superbo, Maria; Gigante, Angelo Fabio; Livrea, Paolo; Defazio, Giovanni

doi:10.1016/j.parkreldis.2014.09.017

Cited by 18 publications

(15 citation statements)

References 9 publications

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“…38 Recently, a study suggested a significant association between PMD and exposure to phenotypically congruent movement disorder models among family members or friendship. 39 Moreover, PMD have been also reported to occur in several members of the same family, 40 again reinforcing the concept that familial illness exposure might play a role in the pathogenesis of the symptoms. …”

Section: Risk Factorsmentioning

confidence: 70%

“…A partial answer comes from evidence suggesting a significant association between PMD and exposure to phenotypically congruent movement disorder models among family members or friends. 39 Yet disease modeling (which can occur both intraindividually and interindividually) does not seem to fully answer such a question. In fact, a recent study assessing the presence of physical events preceding the onset of PMD in 50 consecutive patients found that the phenomenology of the symptoms was plausibly related to the physical trigger in some of the cases, 36 confirming previous suggestions that the nature of the physical precipitating and the affected body parts during the physical illness may influence the subsequent psychogenic symptom.…”

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confidence: 99%

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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: Risk Factorsmentioning

confidence: 70%

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confidence: 99%

Psychogenic nonepileptic seizures and movement disorders

et al. 2016

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“…It occurs more commonly in women (92%) between the ages of 19-66 (mean age 37) [9]. The underlying mechanisms are still poorly understood [10]. In a study, Fasano et al reported that all of sixty-one PFMD patients had phasic or tonic muscular spasms resembling dystonia, most commonly involving the lips (60.7%), followed by eyelids (50.8%), perinasal region (16.4%), and forehead (9.8%) [9].…”

Section: Discussionmentioning

confidence: 99%

“…Somatoform disorders are also very common [3]. A strong association between functional movement disorders and exposure to phenotypically similar movement disorder models was shown [10]. Response to placebo, suggestion or psychotherapy rather than improvement with drug treatments is another finding in these patients [1,3].…”

Section: Discussionmentioning

confidence: 99%

Psychogenic facial movement disorder: a case report

Gözke¹,

Saraçoglu²,

Eser³

et al. 2016

IJCNMH

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Background: Psychogenic movement disorders (PMD) include a wide range of involuntary motor function disturbances that lack an organic cause. Presentation with the form of any known organic movement disorder can be seen. Psychogenic facial movement disorder (PFMD) is an interesting form of PMD and it is not yet fully characterized. Case report: A 44-year-old female patient was evaluated because of deviation of her mouth. She was admitted to another hospital before, in which cranial MRI had been performed and did not demonstrate any abnormality. Steroid therapy had been initiated with the diagnosis of peripheral facial paralysis (PFP). The patient was admitted to our outpatient clinic because the deviation of her mouth was not resolved completely. Neurological examination revealed flattening of the right nasolabial fold and downward retraction of the contralateral edge of the mouth, which disappeared during talking and exacerbated at rest. These findings suggested psychogenic facial dystonia and she was diagnosed as having PFMD. Her steroid therapy was discontinued and treatment with alprazolam was initiated. A prominent resolution of her complaints was observed during post-treatment follow-up control visits. Discussion: Although PFMD is not a rare condition, it is still under-recognized and under-treated. In patients with PFMD, phasic or tonic muscular spasms resembling dystonia can be seen. It involves most commonly the lips. A prompt diagnosis based on positive clinical signs will prevent unnecessary investigations and lessen the morbidity.

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“… 68 , 71 Of interest, a recent case–control study demonstrated a significant association between PMDs and exposure to phenotypically congruent models of movement disorders. 72 The diagnostic process of PMDs in children does not differ from that used for adults. Electromyography can be used to support the diagnosis, although some features are not easily detected and studies can be technically more difficult in children than adults.…”

Section: Methodsmentioning

confidence: 99%