Review Functional Movement Disorder: Assessment and Treatment 2023 Serranová et al

[Andy]

Abstract

Functional movement disorder (FMD) is a common, potentially reversible source of disability in neurology. Over the last two decades, there have been major advances in our understanding of the clinical picture, diagnosis, and management of this condition. Motor presentation is heterogeneous and several non-motor symptoms (e.g., pain, fatigue) are part of the clinical spectrum. The diagnosis should be made by neurologists or neuropsychiatrists based on the presence of positive signs of inconsistency and incongruence with neurological diseases. Promising evidence has accumulated for the efficacy of physiotherapy, psychotherapy, or both in the management of FMD, for a majority of patients.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0733861923000063

 

[SNT Gatchaman]

Can't access this, but I like how the keywords include "Inconsistency; Incongruence;".

Motor presentation is heterogeneous and several non-motor symptoms (e.g., pain, fatigue) are part of the clinical spectrum.

Pain is not motor, though obviously will act to limit motor activity - that's its job. Why is fatigue not motor? I know it's conflated with "tiredness" but at its essence it is limited energy, i.e. motive power.

 

[Sean]

The diagnosis should be made by neurologists or neuropsychiatrists based on the presence of positive signs of inconsistency and incongruence

The inconsistency and incongruence are entirely in the minds of the FMD/FND advocates.

Promising evidence has accumulated for the efficacy of physiotherapy, psychotherapy, or both in the management of FMD, for a majority of patients.

More than two decades on they are still stuck at the 'promising' stage, yet recommending it as if it is a done deal, a mature field.

Sound familiar?