Clinical and demographic characteristics of patients with functional movement disorders: a consecutive cohort study from a specialized clinic

Acta Neurol Belg. 2022 Feb;122(1):97-103. doi: 10.1007/s13760-021-01648-8. Epub 2021 Mar 20.

Abstract

There is a growing interest in functional movement disorders (FMD). However, epidemiological data from large cohorts of patients with FMD are scarce and come mainly from General Neurology and Movement Disorders Clinics. Recently, specialized FMD clinics have been developed and epidemiological data from such clinics may provide useful information. We aimed to describe the clinical and sociodemographic features of patients diagnosed with FMD at our specialized FMD clinic. A standardized form was used to extract data from electronic records from the first-100 consecutive patients who were evaluated and diagnosed with FMD at our clinic from 2017 to 2019. Mean age was 40.88 ± (14.02) years, 63% females. Most patients were within working-age range, but only 16% were working at the time of consultation. Mean disease duration was 3.74 ± 5.73 years and was longer among men. The most common FMD were gait disturbance (42%), tremor (22%) and dystonia (15%). A precipitating event (mainly physical) was reported by 74%. The onset was mostly acute (83%) and the clinical course fluctuating (62%). Pain (64%) and fatigue (44%) were common comorbidities. Potential joint-hypermobility was present in 21%, mostly women (90%) and related to the presence of dystonia. FMD affects men and women mostly in working-age. Gait disturbance was the most common diagnosis, possibly because it causes a higher level of disability that may lead to consultation in a specialized clinic. Non-motor symptoms (pain and fatigue) were frequent in this cohort. Further data from specialized units may contribute to both understanding and management of FMD.

Keywords: Conversion disorders; Functional movement disorders; Functional neurological disorders; Psychogenic.

MeSH terms

  • Adult
  • Cohort Studies
  • Conversion Disorder / epidemiology*
  • Demography
  • Dystonia / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Spain / epidemiology
  • Tremor / epidemiology