Abstract
Functional (psychogenic) movement disorders are frequently seen in neurology outpatient clinics. However, the underlying pathophysiology is still poorly understood and from the clinical perspective, there can be many uncertainties regarding their diagnosis and treatment.
Functional movement disorders are clinically characterized by variability and inconsistency of symptoms that are incongruent with movement disorders known to be caused by an organic neurological disease. Here we review the terminology, definitions, epidemiology and typical presentations of functional movement disorders and their individual forms and clinical diagnostic criteria.
Furthermore, we review advances in our knowledge of the pathophysiology that question the formerly emphasized causal role of psychological factors, and proposes a neurobiological model of the symptom development. Diagnosis of functional movement disorders should be based on the presence of characteristic clinical features and not on exclusion of an organic cause only.
Early diagnosis and its acceptance by the patient are crucial for the prognosis. Management of functional movement disorders involves a multimodal approach with a dominant role of a neurologist, who establishes and communicates the diagnosis and determines treatment.