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Psychogenic Movement Disorders

Diagnosis and Management

  • Therapy in Practice
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Abstract

Psychogenic movement disorders (PMDs) are best defined as hyper- or hypo-kinetic movement disorders, often associated with gait disorders, that cannot be directly attributed to a lesion or dysfunction of the nervous system and which are derived in most cases from psychological or psychiatric causes. There are a variety of PMDs including tremor, dystonia, parkinsonism, gait disorders and, even, unusual forms including paroxysmal dyskinesias. As has been recognised in the recent literature, PMDs cannot be strictly classified into clearly defined psychiatric disorders such as somatoform, dissociative or conversion disorders

In this review, we discuss the diagnosis of various PMDs (including hyper- and hypo-kinetic disorders; and current evidence for underlying comorbid disorders) and the current therapeutic approach to them. The therapy of PMDs is not well established, is very challenging to the clinician, and a better outcome can be achieved in the setting of a team approach involving movement disorders specialists, psychiatrists and therapists who specialise in cognitive-behavioural techniques. Current pharmacological and non-pharmacological approaches to treatment focus on therapy of underlying comorbid psychiatric and psychological issues, although compliance is a major concern

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The authors have provided no information on conflicts of interest directly relevant to the content of this review.

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Authors and Affiliations

  1. Department of Neurology, Parkinson’s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, 6550 Fannin St. #1801, Houston, Texas, 77030, USA

    Madhavi Thomas &  Joseph Jankovic

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  1. Madhavi Thomas
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  2. Joseph Jankovic
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Correspondence to Joseph Jankovic.

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Thomas, M., Jankovic, J. Psychogenic Movement Disorders. CNS Drugs 18, 437–452 (2004). https://doi.org/10.2165/00023210-200418070-00003

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