Psychogenic movement disorders: Diagnosis and management

Madhavi Thomas, Joseph Jankovic

Research output: Contribution to journalReview article

74 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)437-452
Number of pages16
JournalCNS Drugs
Volume18
Issue number7
DOIs
StatePublished - Jun 18 2004

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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