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Functional (psychogenic) movement disorders: merging mind and brain
Abstract
Functional (psychogenic) movement disorders (FMD) are part of the wide spectrum of functional neurological disorders, which together account for over 16% of patients referred to neurology clinics. FMD have been described as a "crisis for neurology" and cause major challenges in terms of diagnosis and treatment. As with other functional disorders, a key issue is the absence of pathophysiological understanding. There has been an influential historical emphasis on causation by emotional trauma, which is not supported by epidemiological studies. The similarity between physical signs in functional disorders and those that occur in feigned illness has also raised important challenges for pathophysiological understanding and has challenged health professionals' attitudes toward patients with these disorders. However, physical signs and selected investigations can help clinicians to reach a positive diagnosis, and modern pathophysiological research is showing an appreciation of the importance of both physical and psychological factors in FMD.
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“6 7 Furthermore, patients with FMDs exhibit altered emotional processing, 8 deviant cognitive beliefs and attentional processes, 9 10 and impaired functioning of the neural network responsible for the sense of agency.”
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InfluentialTreatable movement disorders in children
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Functional Neurological Disorder: A Case of Twisted Toes and Dystonia
McPherson, R. J., Rivera, J. R. S., & Fonarov, I. (2025) · Cureus · doi:10.7759/cureus.88648
“Diagnosis relies not on exclusion alone, but on the identification of positive clinical signs and a detailed history that uncovers inconsistencies and functional features [2,4].”
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Metadata
- Authors
- Edwards, M. J., & Bhatia, K. P.
- Affiliations
- UCL Queen Square Institute of Neurology (GB)
- Corresponding author
- Bhatia, Kailash P
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 11
- Issue
- 3
- Pages
- 250-260
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W2103595952
- Cited by
- 314
- References
- 74
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 12 · 2023: 23 · 2022: 36 · 2021: 19 · 2020: 30 · 2019: 21 · 2018: 19 · 2017: 19 · 2016: 24 · 2015: 17 · 2014: 24 · 2013: 19 · 2012: 8
- FWCI
- 2.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Clinical Neurology › Deep Brain Stimulation and Movement Disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Keywords
- functional movement disorders, psychogenic movement disorders, conversion disorder, pathophysiology, feigned illness, psychological trauma, diagnosis, treatment, mind-brain relationship, psychological factors
- MeSH terms
- Brain, Humans, Movement Disorders
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