FDM Part 6

CLINICAL FEATURESA number of clinical characteristics are associated with FMDs

●Abrupt onset

●History of a precipitating event

●Fast progression to maximum symptom severity and disability

●Movement abnormality that is incongruent with organic disease (eg, bizarre, multiple, or difficult to classify)

●Inconsistency over time with variable amplitude, frequency, or distribution of the movement

●Ability to trigger or relieve the movement with unusual or nonphysiologic intervention (eg, trigger points on the body, application of a tuning fork)

●Decreased movement of the affected body part with distraction

●Increased movement of the affected body part during observation or examination

●Entrainment of movement (eg, tremor) to the frequency of repetitive movements

●Coactivation sign of antagonist muscles

●Deliberate slowness of movement

●Association with false (or “give-way”) weakness, sensory loss, and pain

●Functional disability out of proportion to exam findings

●Unresponsiveness to drugs for organic movement disorders

●Responsiveness to placebo drugs and suggestion

The main FMD syndromes are functional tremor, functional dystonia, functional gait, functional myoclonus, and functional parkinsonism. These are reviewed in the sections below.

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