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Cranial functional (psychogenic) movement disorders

Kaski, D; Bronstein, AM; Edwards, MJ; Stone, J; (2015) Cranial functional (psychogenic) movement disorders. Lancet Neurology , 14 (12) pp. 1196-1205. 10.1016/S1474-4422(15)00226-4. Green open access

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Abstract

Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders—affecting the eyes, face, jaw, tongue, or palate—are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies.

Type: Article
Title: Cranial functional (psychogenic) movement disorders
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/S1474-4422(15)00226-4
Publisher version: http://dx.doi.org/10.1016/S1474-4422(15)00226-4
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Transcranial Magnetic Stimulation, Paroxysmal Positional Vertigo, Nonepileptic Seizures, Hemifacial Spasm, Conversion Disorder, Voluntary Nystagmus, Clinical-features, Convergence Spasm, Palatal Tremor, Motor Symptoms
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
URI: https://discovery.ucl.ac.uk/id/eprint/1553260
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