Psychogenic Movement DisordersDiagnosis and Management
作者:
Madhavi Thomas,
Joseph Jankovic,
期刊:
CNS Drugs
(ADIS Available online 2004)
卷期:
Volume 18,
issue 7
页码: 437-452
ISSN:1172-7047
年代: 2004
出版商: ADIS
关键词: Movement disorders;Dystonia;Tremor;Dyskinesia;Dysphonia;Myoclonus;Parkinsonism;Anxiety;Depression;Somatoform disorders;Cognitive behavioural therapy;Antidepressants, general;Anxiolytics, general
数据来源: ADIS
摘要:
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.
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