Psychogenic movement disorders are a heterogeneous group of conditions characterised by functional motor symptoms that cannot be attributed to any known neurological pathologies. Different mechanisms are still applied to the explanation of these conditions, including exaggeration of normal physiological responses, over- and under-focus on symptoms, symbolic response to psychological trauma, and cultural ideas about the concept of illness. Cases of functional tremor and functional dystonia together account for around 70% of psychogenic movement disorders. Functional myoclonus and functional gait disturbances have also been traditionally included in the psychogenic movement disorder group. Recent research has highlighted the need for clinical diagnostic tests based on positive signs, rather than diagnoses of exclusion of organic pathology in patients with psychiatric conditions. Treatment approaches to psychogenic movement disorders show wide variability and are often empirical. The diagnostic consultation itself could be a key part of the treatment intervention, especially if the clinician adopts non-judgmental approaches and highlights the reversible nature of the functional symptoms as part of psychoeducation.
KeywordsFunctional dystonia Functional gait Functional myoclonus Functional tremor Psychogenic movements
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