Functional movement disorders: Successful treatment with a physical therapy rehabilitation protocol

Czarnecki, Kathrin; Thompson, Jeffrey M.; Seime, Richard J.; Geda, Yonas E.; Duffy, Joseph R.; Ahlskog, J. Eric

doi:10.1016/j.parkreldis.2011.10.011

Cited by 154 publications

(133 citation statements)

References 7 publications

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“…In the largest study of physiotherapy for FMD to date [21], reported on an outpatient physiotherapy program, comprising a 1-week intensive rehabilitation course based on the concept of motor reprogramming. The program specifically focused on the abnormal movement with the idea that it represents an abnormal learned pattern of movement that could be "unlearned" via physiotherapy.…”

Section: Physiotherapymentioning

confidence: 99%

Treatment of Functional (Psychogenic) Movement Disorders

Ricciardi

Edwards

2014

Neurotherapeutics

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Functional (psychogenic) movement disorders are a common source of disability and distress. Despite this, little systematic evidence is available to guide treatment decisions. This situation is likely to have been influenced by the "no man's land" that such patients occupy between neurologists and psychiatrists, often with neither side feeling a clear responsibility or ability to direct management. The aim of this narrative review is to provide an overview of the current state of the evidence regarding management of functional movement disorders. This reveals that there is some evidence to support the use of specific forms of cognitive behavioral therapy and physiotherapy. Such treatments may be facilitated in selected patients with the use of antidepressant medication, and may be more effective for those with severe symptoms when given as part of inpatient multidisciplinary rehabilitation. Other treatments, for example hypnosis and transcranial magnetic stimulation, are of interest, but further evidence is required regarding mechanism of effect and long-term benefit. Though prognosis is poor in general, improvement in symptoms is possible in patients with functional movement disorders, and there is a clear challenge to clinicians and therapists involved in their care to conduct and advocate for high-quality clinical trials.

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Section: Physiotherapymentioning

confidence: 99%

Treatment of Functional (Psychogenic) Movement Disorders

Ricciardi

Edwards

2014

Neurotherapeutics

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“…In another study, psychodynamic psychotherapy was used in a single-blind treatment trial for patients with PMD 56 . Non-psychotherapy modalities including physiotherapy also have been used to treat patients with PMD 57 . A summary of cognitive behavioral approaches used in patients with funtional neurololgical disorders provides a review of studies in a variety of somatoform presentations 58 .…”

Section: Treatment Of Pnes and 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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“…Without clear guidance to care there is a real possibility that patient outcomes remain poor, the symptoms patients experience can become chronic (Carson 2003) Delargy et al (1986), whilst an old study, identified 6 case studies whereby 8-week neurological in-patient rehabilitation programme had been successful in people with medically unexplained paraplegia and quadriplegia. Czarnecki et al (2011) found that an intensive week long out-patient rehabilitation programme involving physiotherapy and occupational improved long-term outcomes for patients with Functional Motor Disorder (FMD). The rehabilitation involved a behavioural approach of motor re-programming rather than general physiotherapy thereby helping patients to reconstruct abnormal motor patterns.…”

Section: Management Of Fnsdmentioning

confidence: 99%

Clinical briefing: functional neurological symptom disorder

Ratcliffe

2017

British Journal of Neuroscience Nursing

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Functional movement disorders: Successful treatment with a physical therapy rehabilitation protocol

Cited by 154 publications

References 7 publications

Treatment of Functional (Psychogenic) Movement Disorders

Treatment of Functional (Psychogenic) Movement Disorders

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

Clinical briefing: functional neurological symptom disorder

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