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Rev Neurol (Paris). 2019 Oct 9. pii: S0035-3787(19)30541-7. doi: 10.1016/j.neurol.2019.08.007. [Epub ahead of print]

Functional movement disorders.

Author information

1
Department of neurology, university hospital of Besançon, 25030 Besançon, France. Electronic address: sgalli@chu-besancon.fr.
2
Department of neurology, university hospital of Besançon, 25030 Besançon, France.
3
Department of neurology, university hospital Bern and university of Bern, Bern, Switzerland.

Abstract

Functional movement disorders (FMD) represent a complex and disabling entity characterized by a broad range of clinical symptoms not explained by a classical neurological disease. In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) added a clinical criterion based on incongruence and inconsistency, supported by recent literature highlighting the role of "positive clinical signs". These clinical signs allow a "rule-in" procedure in making a diagnosis of FMD so that the diagnosis is no longer a "rule-out" or "by default" diagnosis made after exclusion of other neurological conditions. This review summarizes current evidence on common clinical features and highlights bedside signs in FMD, such as tremor, dystonia, myoclonus and parkinsonism. Tics, chorea and hemiballism are also briefly discussed.

KEYWORDS:

Conversion disorder; Functional movement disorder; Functional neurological disorder; Psychogenic

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