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Examiner manoeuvres ‘sensory tricks’ in functional (psychogenic) movement disorders
  1. José Fidel Baizabal-Carvallo1,2,
  2. Joseph Jankovic1
  1. 1Department of Neurology, Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA
  2. 2University of Guanajuato, Mexico
  1. Correspondence to Dr José Fidel Baizabal-Carvallo, Department of Internal Medicine, University of Guanajuato, 20 de Enero no. 927, León, Guanajuato, México C.P. 37320; baizabaljf{at}hotmail.com

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Introduction

Sensory tricks, defined as ‘episodic and specific manoeuvres that temporarily improve dystonia in a manner that is not easily physiologically perceived as necessary to counteract the involuntary movement’, are well-recognised features of organic dystonia.1 The term ‘alleviating manoeuvres’ (AlM) has been proposed as a more appropriate term because ‘sensory trick’ suggests that only sensory input is required, and the word ‘trick’ wrongly implies that is ‘fake’.2 ‘Reverse sensory trick’ is the term used when a manoeuvre worsens dystonia, the latter can also be called ‘aggravating manoeuvres’ (AgM). AlMs are usually internally generated and rarely effective when applied by another person. However, patients with functional (psychogenic) movement disorders (FMDs) may show improvement or aggravation with stimuli applied by another person, that is, examiner manoeuvre (EM). In this study, we aimed to assess the frequency and characterise the clinical features of EMs in a large cohort of patients with FMDs.

Patients and methods

We reviewed medical records and video recordings of all cases of FMDs evaluated at Baylor College of Medicine Movement Disorders Clinic during a 2-year period. We assessed the stimuli type that improved or worsened the …

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