Treatment of Functional (Psychogenic) Movement Disorders

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• 作者：Luciana Ricciardi (1) (2)
  Mark J. Edwards (1)
  
• 关键词：Functional movement disorders ; Psychogenic ; Physiotherapy ; Cognitive behavioral therapy
• 刊名：Neurotherapeutics
• 出版年：2014
• 出版时间：January 2014
• 年：2014
• 卷：11
• 期：1
• 页码：201-207
• 全文大小：169 KB
• 作者单位：Luciana Ricciardi (1) (2)
  Mark J. Edwards (1)
  
  1. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, WC1N 3BG, UK
  2. Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
  
• ISSN：1878-7479

文摘

Functional (psychogenic) movement disorders are a common source of disability and distress. Despite this, little systematic evidence is available to guide treatment decisions. This situation is likely to have been influenced by the “no man’s land-that such patients occupy between neurologists and psychiatrists, often with neither side feeling a clear responsibility or ability to direct management. The aim of this narrative review is to provide an overview of the current state of the evidence regarding management of functional movement disorders. This reveals that there is some evidence to support the use of specific forms of cognitive behavioral therapy and physiotherapy. Such treatments may be facilitated in selected patients with the use of antidepressant medication, and may be more effective for those with severe symptoms when given as part of inpatient multidisciplinary rehabilitation. Other treatments, for example hypnosis and transcranial magnetic stimulation, are of interest, but further evidence is required regarding mechanism of effect and long-term benefit. Though prognosis is poor in general, improvement in symptoms is possible in patients with functional movement disorders, and there is a clear challenge to clinicians and therapists involved in their care to conduct and advocate for high-quality clinical trials.