[Psychogenic movement disorders]

Abstract

Psychogenic Movement Disorders (PMDs) are a subtype of conversion disorder, classified under somatoform disorders in the DSM. Diagnosis and treatment of PMDs are challenging for both neurologists and psychiatrists. Typical clinical characteristics of these disorders are acute onset, fast progression, movement patterns incongruent with organic movement disorders, distractibility, variability and simultaneous occurrence of various abnormal movements and dysfunctions. The diagnosis of PMDs should not be regarded as a diagnosis of exclusion and electrophysiology is not always helpful. The cause of PMDs is unknown and the underlying brain mechanisms remain uncertain. However, recent functional magnetic resonance imaging studies have demonstrated altered blood flow in conversion disorders that may reflect changes in synaptic activity. Involvement of allied health professionals and psychotherapy continue to be the mainstay of treatment.