Functional Motor Disorders Mimicking Symptoms Upon Resolution of Cerebrovascular Disease

Mov Disord Clin Pract. 2020 May 31;7(5):552-554. doi: 10.1002/mdc3.12972. eCollection 2020 Jul.

Abstract

Background: Functional motor disorders encompass a variety of manifestations characterized by abnormal movements that are clinically incongruent with those known to be caused by neurological diseases.

Cases: We report 2 cases in which functional motor disorders developed after complete recovery of motor symptoms originating from underlying vascular brain lesions. The first case describes a young woman who developed a motor and sensory hemisyndrome after surgical removal of a postrolandic cavernoma. The second describes a 16-year-old girl who presented with a mixed component tremor after ventricular derivation and endovascular embolization for rupture of a brainstem arteriovenous malformation.

Conclusion: Motor symptoms and signs attributed to an underlying lesion may trigger "pure" functional motor disorders. In such cases, the differential diagnosis may be even more challenging. However, diagnosis of a functional rather than a defined structural disorder can be achieved by a "positive diagnostic process," considering the findings of internal inconsistency and incongruity.

Keywords: disease model; distractive maneuvers; functional motor disorders; inconsistency and incongruity; vascular lesion.

Publication types

  • Case Reports