Skip to main content

Functional Paroxysmal Movement Disorders

  • Chapter
  • First Online:
  • 436 Accesses

Abstract

Functional paroxysmal movement disorders are a phenomenologically diverse group of functional movement disorders with often complex clinical presentations. This may lead to significant diagnostic (and therefore therapeutic) delay. However, with knowledge of the typical presentations of monogenic paroxysmal movement disorders, confident diagnosis is possible in many patients. Variability of clinical presentation, including triggers and attack duration, the presence of additional functional neurological signs and adult onset are all features that are associated with functional paroxysmal movement disorders. In this chapter we outline the diagnostic process and discuss how to move from diagnosis to effective management.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   69.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Bhatia KP. Paroxysmal dyskinesias. Mov Disord. 2011;26(6):1157–65.

    Article  Google Scholar 

  2. Erro R, Sheerin UM, Bhatia KP. Paroxysmal dyskinesias revisited: a review of 500 genetically proven cases and a new classification. Mov Disord. 2014;29(9):1108–16.

    Article  Google Scholar 

  3. Ganos C, Aguirregomozcorta M, Batla A, Stamelou M, Schwingenschuh P, Münchau A, et al. Psychogenic paroxysmal movement disorders – clinical features and diagnostic clues. Parkinsonism Relat Disord. 2014;20(1):41–6.

    Article  Google Scholar 

  4. Erro R, Tinazzi M. Functional (psychogenic) paroxysms: the diagnosis is in the eye of the beholder. Parkinsonism Relat Disord. 2014;20(3):343–4.

    Article  Google Scholar 

  5. Ganos C, Edwards MJ, Bhatia KP. The phenomenology of functional (psychogenic) dystonia. Mov Disord Clin Pract. 2014;1:36–44.

    Article  Google Scholar 

  6. Fasano A, Valadas A, Bhatia KP, Prashanth LK, Lang AE, Munhoz RP, et al. Psychogenic facial movement disorders: clinical features and associated conditions. Mov Disord. 2012;27(12):1544–51.

    Article  Google Scholar 

  7. Kaski D, Bronstein AM, Edwards MJ, Stone J. Cranial functional (psychogenic) movement disorders. Lancet Neurol. 2015;14(12):1196–205.

    Article  Google Scholar 

  8. Stamey W, Jankovic J. The other Babinski sign in hemifacial spasm. Neurology. 2007;69(4):402–4.

    Article  Google Scholar 

  9. Brown P, Thompson PD, Rothwell JC, Day BL, Marsden CD. Axial myoclonus of propriospinal origin. Brain. 1991;114(Pt 1A):197–214.

    PubMed  Google Scholar 

  10. van der Salm SM, Erro R, Cordivari C, Edwards MJ, Koelman JH, Ende TV, et al. Propriospinal myoclonus: clinical reappraisal and review of literature. Neurology. 2014;83(20):1862–70.

    Article  Google Scholar 

  11. Erro R, Bhatia KP, Edwards MJ, Farmer SF, Cordivari C. Clinical diagnosis of propriospinal myoclonus is unreliable: an electrophysiologic study. Mov Disord. 2013;28(13):1868–73.

    Article  Google Scholar 

  12. Baizabal-Carvallo JF, Jankovic J. The clinical features of psychogenic movement disorders resembling tics. J Neurol Neurosurg Psychiatry. 2014;85(5):573–5.

    Article  Google Scholar 

  13. Demartini B, Ricciardi L, Parees I, Ganos C, Bhatia KP, Edwards MJ. A positive diagnosis of functional (psychogenic) tics. Eur J Neurol. 2015;22(3):527–e36.

    Article  CAS  Google Scholar 

  14. Ganos C, Edwards MJ, Muller-Vahl K. “I swear it is Tourette’s!”: on functional coprolalia and other tic-like vocalizations. Psychiatry Res. 2016;246:821–6.

    Article  Google Scholar 

  15. Ganos C, Erro R, Cavanna AE, Bhatia KP. Functional tics and echophenomena. Parkinsonism Relat Disord. 2014;20(12):1440–1.

    Article  Google Scholar 

  16. Fahn S. Psychogenic movement disorders. In: Marsden CD, Fahn S, editors. Movement disorders. 3rd ed. Oxford: Butterworth-Heineman; 1994. p. 359–72.

    Google Scholar 

  17. Parees I, Kojovic M, Pires C, Rubio-Agusti I, Saifee TA, Sadnicka A, et al. Physical precipitating factors in functional movement disorders. J Neurol Sci. 2014;338(1–2):174–7.

    Article  Google Scholar 

  18. Bhatia KP, Marsden CD. The behavioural and motor consequences of focal lesions of the basal ganglia in man. Brain. 1994;117(Pt 4):859–76.

    Article  Google Scholar 

  19. Zittel S, Bester M, Gerloff C, Munchau A, Leypoldt F. Symptomatic paroxysmal kinesigenic choreoathetosis as primary manifestation of multiple sclerosis. J Neurol. 2012;259(3):557–8.

    Article  Google Scholar 

  20. Espay AJ, Aybek S, Carson A, Edwards MJ, Goldstein LH, Hallett M, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol. 2018;75(9):1132–41.

    Article  Google Scholar 

  21. Nielsen G, Buszewicz M, Stevenson F, Hunter R, Holt K, Dudziec M, et al. Randomised feasibility study of physiotherapy for patients with functional motor symptoms. J Neurol Neurosurg Psychiatry. 2017;88(6):484–90.

    Article  CAS  Google Scholar 

  22. Goldstein LH, Deale AC, Mitchell-O’Malley SJ, Toone BK, Mellers JD. An evaluation of cognitive behavioral therapy as a treatment for dissociative seizures: a pilot study. Cogn Behav Neurol. 2004;17(1):41–9.

    Article  Google Scholar 

  23. Goldstein LH, Chalder T, Chigwedere C, Khondoker MR, Moriarty J, Toone BK, et al. Cognitive-behavioral therapy for psychogenic nonepileptic seizures: a pilot RCT. Neurology. 2010;74(24):1986–94.

    Article  CAS  Google Scholar 

  24. LaFrance WC Jr, Baird GL, Barry JJ, Blum AS, Frank Webb A, Keitner GI, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiat. 2014;71(9):997–1005.

    Article  Google Scholar 

  25. Erro R, Brigo F, Trinka E, Turri G, Edwards MJ, Tinazzi M. Psychogenic nonepileptic seizures and movement disorders: A comparative review. Neurol Clin Pract. 2016;6(2):138–49.

    Google Scholar 

  26. Dallocchio C, Tinazzi M, Bombieri F, Arnó N, Erro R. Cognitive Behavioural Therapy and Adjunctive Physical Activity for Functional Movement Disorders (Conversion Disorder): A Pilot, Single-Blinded, Randomized Study. Psychother Psychosom. 2016;85(6):381–83.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christos Ganos .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ganos, C., Edwards, M.J. (2021). Functional Paroxysmal Movement Disorders. In: Sethi, K.D., Erro, R., Bhatia, K.P. (eds) Paroxysmal Movement Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-53721-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-53721-0_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-53720-3

  • Online ISBN: 978-3-030-53721-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics