Functional Movement Disorders in Elderly

Chouksey, Anjali; Pandey, Sanjay

doi:10.5334/tohm.463

Cited by 8 publications

(14 citation statements)

References 10 publications

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“…However, 10% of our patients were older than 60, which roughly matches the finding that 21% of patients with functional movement disorder have onsets after 60 years old [46][47][48][49]. Similar to FS, functional movement disorders are abnormal movements that may represent physical manifestations of psychological dysfunction [50].…”

Section: Kerr 15supporting

confidence: 84%

Functional seizures across the adult lifespan: female sex, delay to diagnosis and disability

Kerr

Sreenivasan

Allas

et al. 2021

Seizure

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Kerr 15supporting

confidence: 84%

Functional seizures across the adult lifespan: female sex, delay to diagnosis and disability

Kerr

Sreenivasan

Allas

et al. 2021

Seizure

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“…Functional tremor and gait disorders were the most commonly reported clinical manifestations in patients with elderly FMD onset. 5,8,9 Consistent with previous studies, tremor (47.1%) and gait disorders (29.4%) were also the most frequently reported symptoms in our cohort of patients with elderly FMD onset. A previous study indicated that functional gait phenotype was significantly more prevalent in individual with elderly FMD onset than in the younger population.…”

Section: Discussionsupporting

confidence: 92%

“…Younger adults are more commonly affected by FMD with a mean age at FMD onset ranging from 36.9 to 50 years old 4–6 . Few studies have dealt with FMD in the elderly pointing out that 10–21% of patients may have onset of their symptoms after the age of 60 5–9 . However, these studies may have not adequately addressed the presence of FMD in the elderly and how it differs from the younger age group with FMD.…”

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confidence: 99%

Elderly Onset of Functional Motor Disorders: Clinical Correlates from the Italian Registry

Geroin,

Petracca,

Di Tella

et al. 2023

Movement Disord Clin Pract

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BackgroundFunctional motor disorders (FMD) are a frequent neurological condition affecting patients with movement disorders. Commonly described in younger adults, their manifestation can be also associated to an elderly onset.ObjectiveTo assess the prevalence and describe the clinical manifestations of FMD with elderly and younger onset and their relationship with demographical and clinical variables.MethodsWe recruited patients with a ‘clinically definite’ diagnosis of FMD from the Italian Registry of FMD. Patients underwent extensive clinical assessments. For elderly onset, we set a chronological cut‐off at 65 years or older according to WHO definition. Multivariate regression models were implemented to estimate adjusted odds ratio of elderly FMD onset related to clinical characteristics.ResultsAmong the 410 patients, 34 (8.2%) experienced elderly‐onset FMD, with a mean age at onset of 70.9 years. The most common phenotype was tremor (47.1%), followed by gait disorders, weakness, and dystonia (29.4%, 23.5%, 14.7% respectively). Eleven elderly had a combined phenomenology: 9 exhibited two phenotypes, 2 had three phenotypes. Weakness was isolated in 3/8 patients and combined with another phenotype in 5/8, manifesting as paraplegia (n=4); upper limb diplegia (n=2), hemiparesis/hemiplegia (n=1), and tetraparesis/tetraplegia (n=1). Non‐motor and other functional neurological disorders occurred more frequently in the younger group (89.1%) than the elderly (73.5%). Neurological and non‐neurological comorbidities were more prevalent in the elderly group (82.4%) as opposed to the younger (32.7%). In a multivariate regression analysis, elderly‐onset FMD was significantly associated with neurological comorbidities, including parkinsonism (OR 6.73) and cerebrovascular diseases (OR 5.48).ConclusionsThese results highlight the importance of achieving an accurate diagnosis of FMD in the elderly, as it is crucial for effectively managing FMD symptoms and addressing neurological comorbidities.This article is protected by copyright. All rights reserved.

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“…29 Another study reported that amongst 117 patients diagnosed with FMD at their center, 15% had an onset after the age of 60 years. 30 FNDs in children are common but differ from that in adults in terms of risk factors, phenomenology, and treatment response. 31 In general, FNDs are considered sporadic disorders but family history is described and may be an additional risk factor.…”

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confidence: 99%

Functional Neurological Disorders

Mishra

Pandey

2022

The Neurologist

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Background: Functional neurological disorders (FNDs) are common but often misdiagnosed. Review Summary: The incidence of FNDs is between 4 and 12 per 100,000, comparable to multiple sclerosis and amyotrophic lateral sclerosis, and it is the second most common diagnosis in neurology clinics. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, and history of other somatic symptoms. Anxiety and depression are common, but not necessarily more than in the general population. Although there are no tests currently capable of demonstrating whether symptoms are willfully produced, there may not be a clear categorical difference between voluntary and involuntary symptoms. The prognosis of an FND is linked to early diagnosis and symptom duration, but unfortunately, the majority of the patients are diagnosed after considerable delays. Conclusions: A positive diagnosis of FNDs can be made on the basis of history and neurological signs without reliance on psychological stressors. Past sensitizing events and neurobiological abnormalities contribute to the pathogenesis of FNDs. Physical rehabilitation and psychological interventions alone or in combination are helpful in the treatment.

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Functional Movement Disorders in Elderly

Cited by 8 publications

References 10 publications

Functional seizures across the adult lifespan: female sex, delay to diagnosis and disability

Functional seizures across the adult lifespan: female sex, delay to diagnosis and disability

Elderly Onset of Functional Motor Disorders: Clinical Correlates from the Italian Registry

Functional Neurological Disorders

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