Nothing Beats Expert History and Neurological Examination in Diagnosing Functional Movement Disorders

Clinical examination by movement disorders experts determined diagnoses more often than psychiatric evaluation or the Bereitschafts potential did.

Functional (psychogenic) movement disorders are tricky to diagnose. Other hyperkinetic disorders such as myoclonus and tics can, likewise, be difficult to separate from functional disorders. Expert clinicians are often asked to clarify diagnosis. In this study, 39 expert movement disorders clinicians were provided videos and information on 60 subjects. The experts were asked which of the following five pieces of information was decisive for diagnosis: visual first impression of the patient, medical history, neurological examination, the Bereitschafts potential, and psychiatric evaluation. Switches in diagnosis after steps were also analyzed.

The first impression of the patient was decisive in 19% of cases, whereas medical history was decisiv…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)