Table 2

Clinical signs which can be shown to a patient with functional motor disorder to demonstrate the diagnosis and potential for reversibility and examples of how to discuss it with patients

Hoover's sign
Weakness of hip extension which returns to normal with contralateral hip flexion against resistance
“I can see that when you try to push that leg down on the floor its weak, In fact the harder you try the weaker it becomes. But when you are lifting up your other leg, can you feel that the movement in your bad leg comes back to normal? Your affected leg is working much better when you move your good leg. What this tells me is that your brain is having difficulty sending messages to the leg but that problem improves when you are distracted and trying to move your other leg. This also shows us that the weakness must be reversible/cannot be due to damage”
Hip abductor sign
Weakness of hip abduction which returns to normal with contralateral hip abduction against resistance
Similar to Hoover’s sign
Distraction or entrainment of a tremor
Abolishing tremor by asking the patient to copy rhythmical movements or generate ballistic movements with the contralateral limb (ie, index to thumb tapping at different speeds)
“When you are trying to copy the movement in your good hand can you see that the tremor in your affected hand improves? That is typical of functional tremor”