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Clinical features of functional (psychogenic) eye movement disorders
  1. Diego Kaski1,2,3,
  2. Vidushi Pradhan1,
  3. Adolfo M Bronstein1,2
  1. 1 Neuro-otology Unit, Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, UK
  2. 2 Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK
  3. 3 Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK
  1. Correspondence to Dr Diego Kaski, Department of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; d.kaski{at}imperial.ac.uk

https://doi.org/10.1136/jnnp-2016-313608

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    Introduction

    Despite increasing awareness of the high prevalence of functional neurological symptoms, there has been only one recent clinical evaluation of functional eye movement disorders, but this study reported only functional (psychogenic) oculogyric crises, opsoclonus and flutter.1 The aim of this retrospective study was to examine the clinical phenotype and range of functional eye movement disorders, and to report their prevalence across two neuro-otology outpatient clinics.

    Methods

    We performed a systematic retrospective search of the hospital's electronic patient database for patients attending a neurologist-led (AMB) neuro-otology outpatient clinic at Charing Cross Hospital, London, from August 2013 to August 2015 (Clinic 1), and at the National Hospital for Neurology and Neurosurgery, London, from August 2014 to August 2015 (Clinic 2). The terms ‘functional’ or ‘non-organic’ or ‘psychogenic’ or ‘psychosomatic’ or ‘somatoform’ or ‘conversion’ and ‘ocular’ or ‘eyes’ or ‘accommodation’ or ‘near reflex’ or ‘voluntary nystagmus’ or ‘convergence spasm’ or ‘convergent spasm’ or ‘spasm of the near reflex’ or ‘convergence’ were searched for.

    From those clinic letters identified from the above searches, patients were included in the study when clinical signs on eye movement examination were deemed to be functional (psychogenic) by the senior clinician (AMB), using chart and video reviews. Table 1 shows the diagnostic categories used.

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    Table 1

    Diagnostic features used to characterise functional (psychogenic) eye movement …

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    Footnotes

    • Contributors VP performed the patient searches, compiled the table and assisted in drafting the manuscript. DK performed patient searches, compiled tables and figures, reviewed clinical data and compiled the manuscript. AMB reviewed all patient data, compiled the manuscript and approved its final version.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.