Search

The stigma associated with functional neurological disorder (FND) is greater than that associated with other neurological conditions, seriously affecting the quality of life of patients and increasing the burden on caregivers. This article reviews the concept, the current situation and harms, the influence factors and intervention strategies of FND stigma. The aim is to further develop our country as a reference for the study of stigma in FND.

Functional tremor is the most common subtype of functional movement disorder (FMD). At present, there is no "gold standard" for diagnosis. Most clinical manifestations coincide with organic tremor, which can easily lead to misdiagnosis and mistreatment. Characteristic electrophysiological manifestations can provide objective and repeatable diagnostic information, effectively supplement the history and physical examination, and can also be used in the differential diagnosis from organic tremor. This article reviews the electrophysiological characteristics of functional tremor and its application in diagnosis and differential diagnosis, in order to improve the clinical understanding of this disease.

Functional neurological disorder (FND) is common in clinic, individual susceptibility and social environment factors play an important role in its pathogenesis, and the prognosis is poor. In recent years, there have been three new diagnostic categories of FND, long corona virus disease (COVID) syndrome, Havana syndrome and TikTok tic syndrome. This article reviews the pathogenesis, clinical manifestations, diagnostic criteria and treatment of long COVID syndrome, Havana syndrome and TikTok tic syndrome in order to assist the diagnosis and treatment of the disease.

Objective To preliminarily summarize the epidemiological and clinical characteristics of functional movement disorder (FMD) based on movement disorders clinic in China. Methods and Results A total of 593 patients with movement disorders newly diagnosed in movement disorders clinic of 22 clinical medical centers from August to September in 2023 were included, including 37 patients (6.24%) with FMD and 556 patients (93.76%) with organic movement disorder. Comparison of the epidemiological characteristics of the 2 groups, the proportions of corona virus disease (COVID⁃19) infection (χ2 = 4.217, P = 0.040) and psychopsychological symptoms (χ2 = 18.694, P = 0.000) in the FMD group were higher than those in the organic movement disorder group, while age (t = 3.757, P = 0.000), age of onset (t = 3.720, P = 0.000) and proportion of hypertension (χ2 = 4.736, P = 0.030) were lower than those in the organic movement disorder group. Comparison of the clinical characteristics of the 2 groups, the FMD group had higher proportions of tremor (χ2 = 3.955, P = 0.047) and myoclonus (Fisher′s exact probability: P = 0.011) than the organic movement disorder group, and the proportions of parkinsonism (χ2 = 8.491, P = 0.004) and gait disorder (χ2 = 5.028, P = 0.025) were lower than those in the organic movement disorder group. Conclusions The age and age of onset, as well as the proportions of COVID⁃19 infection, hypertension, psychopsychological symptoms, tremor, myoclonus, parkinsonism and gait disorder with FMD were different from those with organic movement disorder in China.

Objective To explore changes of brain structure in patients with functional movement disorder (FMD) and their correlation with disease severity. Methods Nine patients with FMD (FMD group) as well as 10 gender⁃ and age⁃matched healthy volunteers (control group) were recruited in Ruijin Hospital, Shanghai Jiaotong University School of Medicine, from May to October 2023, and then they underwent MRI. Simplified Functional Movement Disorder Rating Scale (S ⁃FMDRS) was used to assess movement disorder symptoms and severity. Clinical Global Impression ⁃ Severity (CGI ⁃ S) was used to evaluate disease severity. Somatoform Dissociation Questionnaire ⁃ 20 (SDQ ⁃20) was used to assess body dissociation. Chinese version of Maltreatment and Abuse Chronology of Exposure (MACE) was used to assess childhood abuse situation. 36⁃Item Short Form of Health Survey (SF⁃36) was used to assess health status. Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale 17 (HAMD⁃17) were used to evaluate anxiety and depression. Results Compared with the control group, the FMD group exhibited higher scores on SDQ⁃20 (Z = 2.259, P = 0.028) and Chinese version of MACE (t = ⁃ 3.570, P = 0.002) as well as HAMA (t = ⁃ 3.999, P = 0.001), while SF⁃36 scores for vitality (t = 3.091, P = 0.009) and social functioning (t = 2.275, P = 0.046) were lower in the FMD group. Cortical thickness was greater in the FMD group in the right inferior occipital gyrus and sulcus cortex (t = ⁃ 2.924, P = 0.009), right anterior cingulate gyrus and sulcus cortex (t = ⁃ 3.286, P = 0.004), right orbitofrontal cortex (t = ⁃ 2.381, P = 0.029), while thickness in the left subcallosal area (t = 2.492, P = 0.023) and left paracentral lobule gyrus and sulcus (t = 2.139, P = 0.047), as well as volume of the right cerebellar white matter (t = 2.685, P = 0.016), left cerebellar white matter (t = 2.121, P = 0.049), and the middle posterior region of the corpus callosum (t = 2.550, P = 0.021) were smaller than those of the control group. Correlation analysis revealed left cerebellar white matter were positively correlated with disease duration (r = 0.837, P = 0.038), while cortical thickness in the left subcallosal area were negatively correlated with disease duration (r = ⁃ 0.831, P = 0.040). Conclusions There are structural changes in the limbic system, sensorimotor area, visual cortex, and certain white matter regions in the brains of FMD patients, and several regions were correlated with the disease duration.

Functional movement disorder (FMD) is a common subtype of functional neurological disorder (FND). Currently, multi⁃disciplinary team (MDT) is recommended for FMD. In addition to drug and psychological treatment, rehabilitation treatment is also of great value. Rehabilitation treatment improve the motor control function of patients through the comprehensive application of physical therapy, non ⁃ invasive nerve stimulation therapy and occupational therapy, enhance the activities of daily living (ADL). This article reviews the progress of rehabilitation treatment for FMD, so as to provide theoretical basis for accurate rehabilitation treatment for FMD.

Functional movement disorder (FMD) is a common subtype of functional neurological disorder (FND), mainly manifested as gait abnormality, tremor, dystonia, postural abnormality, and so on. In recent years, researchers have adopted multi⁃ disciplinary team (MDT) to improve the treatment effect of FMD, among which cognitive behavioral therapy (CBT) has been widely used as an effective psychotherapy program. This article reviews the research progress of CBT for FMD in order to provide guidance for clinical treatment.

Functional movement disorder (FMD) is a common type of conversion/dissociative disorder. In recent years, the continuous development of imaging techniques such as fMRI, DTI and PET, as well as analytical methods such as morphological analysis and fiber tract tracking, not only provides technical support for the study of neurobiological mechanisms of FMD, but also has important value for its differential diagnosis, efficacy evaluation and prognosis prediction. This article reviews the progress of imaging research on FMD, so as to provide basis for diagnosis, treatment and pathophysiological mechanism of the disease.

Neurophysiological technique uses the bioelectrical principle to record the spontaneous or external stimulation⁃induced electrical activities of the central or peripheral nervous system. Due to the essential difference in the pathophysiological mechanism of functional and organic movement disorders, neurophysiology is of great significance for the diagnosis and differential diagnosis of the central and peripheral nervous systems. In order to improve the understanding of the pathogenesis of functional movement disorder (FMD) and provide the basis for the accurate diagnosis, this paper reviews the common clinical neurophysiological techniques and their application in FMD.

Functional neurological disorder (FND) is a kind of voluntary motor or sensory system disease with definite symptoms. As a kind of nervous system disease which can be included in chronic disease management but not easy to identify, its increasing number of patients and social burden have aroused great attention in society. Based on the author′s clinical practice and thinking on FND in recent years, this paper analyzes how to further strengthen the diagnosis, treatment and management of FND in China, and puts forward relevant countermeasures and suggestions, so as to achieve early detection, early diagnosis and early treatment of diseases, and improve the quality of life of patients.

Functional movement disorder (FMD) is a common functional neurological disorder (FND), which is mainly manifested as subjective dyskinesia and cannot be explained by existing diseases. Although there was no record of the corresponding disease name in ancient Chinese medicine, the disease caused by mental and psychological factors has been long recognized, and a large number of documents have been left to record the diagnosis and treatment process of such diseases. In this paper, three typical ancient medical cases related to FMD were reviewed, and the traditional Chinese medicine diagnosis and treatment ideas and modern medicine recognition of these diseases were systematically sorted out, so as to broaden the clinical treatment ideas of the disease.

Objective To summarize the clinical characteristics of children with functional neurological disorder (FND) presented with motor symptoms. Methods and Results Total 18 children with FND mainly manifested by motor symptoms were admitted to Department of Pediatrics in Peking University Third Hospital from July 2017 to June 2023. The clinical phenotypes included 8 cases of myoclonus, 3 of tremor, 3 of myasthenia, 2 of dystonia, and 2 of psychogenic non⁃epileptic seizure (PNES). There was no overlap of movement disorder symptoms in all patients. Of the 8 cases with clonus, 5 showed bilateral symmetry myoclonus, and 3 involved only the right upper limb or right hand. Three cases of tremor presented with rapid tremor on one or both upper limbs or hands. Three patients with myasthenia showed weakness of both lower limbs and inability to walk. Of the 2 patients with dystonia, one had paroxysmal upper limb and trunk torsion postural abnormalities, and one had intermittent muscle tone and hip flexion of the lower limb. Two cases of PNES were characterized by gaze, neck tilt, limb extension and flexion tremors, and tapping. One case had mild abnormal EEG and repeated small chromosome fragments. Tirteen cases had mild symptoms and good prognosis after treatment. Five cases with severe symptoms combined with mental symptoms were transferred to Department of Psychiatry for further treatment. Conclusions The most common manifestations of children with FND presented with motor symptoms are myoclonus, tremor and myasthenia, which can be traced to related causes, and may be accompanied by a variety of other physical or psychiatric symptoms. Some children need to be referred to Department of Psychiatric for further treatment.

Functional movement disorder (FMD) is a common category of dissociative/conversion disorder and has become representative disease spectrum of functional neurological disorder (FND) and an important branch of movement disorder diseases. In 2021, we introduced the Chinese expert consensus on the diagnosis and treatment of FMD domestically for the first time. With the progressively understanding of FMD and clinical experiences from FND ⁃ multi ⁃ disciplinary team (MDT), this article summarizes the research progress in FMD diagnosis and treatment over the past two years. Building upon the initial version, it provides a more detailed overview of FMD′s epidemiology, pathophysiology, clinical manifestations, auxiliary examinations, diagnosis and differential diagnosis, treatment and prognosis, along with relevant recommended insights. The aim is to offer more specific diagnostic and therapeutic foundations for clinicians.

Functional myoclonus is a group of paroxysmal abnormal movements, which is one of the common types of functional movement disorder (FMD). The clinical characteristics include sudden occurrence and sudden arrest, inconsistent symptoms, distraction, entrainment, and placebo or suggestion therapy is effective. Long burst duration, variable muscle recruitment pattern and relatively characteristic bereitschafts potential (BP) can be seen in neuroelectrophysiological examination. The diagnosis is mainly based on the positive clinical symptoms and electrophysiological examination results. At present, there is no unified guideline for treatment, which recommends psychotherapy, physical therapy and multidisciplinary cooperation. This article reviews the clinical characteristics, diagnosis and differential diagnosis, treatment and prognosis of functional myoclonus, in order to help clinical early accurate diagnosis, timely treatment, and improve patient prognosis.

Functional limb weakness is a common functional motor disorder, and its clinical diagnosis is mainly based on the medical history, neurological examinations and patients' positive signs. It is prone to misdiagnosis in the clinical practice, treatment requires diagnostic interpretation, physical therapy, and psychological therapy in a multi⁃disciplinary team pattern. This article reviews the progress in clinical manifestations, diagnosis, differential diagnosis, and the treatment of functional limb weakness, to help clinicians diagnose and treat functional limb weakness effectively in clinical practice, improving patients' prognosis.

Functional dystonia is one of the most common phenotypes of functional movement disorder (FMD). Multiple clinical manifestations of functional dystonia are complex and some symptoms overlap with idiopathic dystonia. The diagnosis of functional dystonia is challenging and the overall progenosis is poor. This article reviews the clinical manifestations, auxiliary examination, diagnosis and differential diagnosis, treatment and prognosis of functional dystonia, in order to improve clinical cognition and promote the multi‑disciplinary team (MDT) of functional dystonia.

Functional parkinsonism (FP) is a disorder caused by psychological factors rather than neurodegeneration. Functional parkinsonism has a great influence on patients' quality of life and daily function. However, due to overlapping with some of the symptoms of Parkinson's disease (PD), the diagnosis of functional parkinsonism is often delayed or omitted. Early identification and diagnosis of functional parkinsonism is challenging and crucial to the treatment and prognosis of patients. This review summarizes the importance of clinical positive signs and auxiliary examinations in the diagnosis and differential diagnosis of functional parkinsonism. The differences of clinical features between functional parkinsonism and PD were compared in detail. This review aims to improve clinicians' diagnosis, differential diagnosis and treatment capabilities of functional parkinsonism.

Functional gait disorder (FGD) is a common subtype of functional movement disorder (FMD), mainly characterized by instability, lameness and Parkinson's gait. The clinical manifestations of FGD are the same as those of other types of gait disorder, with the possibility of misdiagnosis. However, there are significant differences in the treatment principles between them, so clear diagnosis and accurate treatment are crucial to improve patients' symptoms and prognosis. This paper aims to systematically review the epidemiological characteristics, clinical manifestations, auxiliary examination, diagnosis and differential diagnosis, treatment and prognosis of FGD, in order to improve the understanding of clinicians.

Objective To investigate the cerebral perfusion difference between tremor dominant Parkinson's disease (PD) and essential tremor (ET). Methods Twenty⁃five patients with tremor dominant PD and 23 with ET admitted to Zhongshan Hospital Fudan University from October 2016 to December 2018 were included, and 39 normal controls matched by sex and age were recruited. Cerebral blood flow (CBF) was acquired through three dimensional pseudo ⁃ continuous arterial spin labeling (3D ⁃ pCASL). Results Significant differences of CBF were observed among 3 groups in bilateral middle frontal gyrus, caudate nucleus, posterior cerebellar lobes, left superior frontal gyrus, left parahippocampal gyrus, left inferior occipital gyrus, left lingual gyrus, left precuneus, right orbital middle frontal gyrus, right cuneus, right superior occipital gyrus, right middle occipital gyrus (P < 0.05, for all; AlphaSim correction). Compared with the control group, PD patients demonstrated decreased CBF in the left superior frontal gyrus (t = 4.891, P < 0.05), left middle frontal gyrus (t = 4.993, P < 0.05) and left inferior occipital gyrus (t = 4.403, P < 0.05), as well as increased CBF in the right orbital middle frontal gyrus (t = 4.162, P < 0.05). Compared with the ET group, PD patients demonstrated decreased CBF in the left middle frontal gyrus (t = 5.471, P < 0.05), right middle frontal gyrus (t = 4.798, P < 0.05), left lingual gyrus (t = 4.972, P < 0.05), left inferior parietal gyrus (t = 4.532, P < 0.05), left caudate nucleus (t = 5.001, P < 0.05) and right posterior cerebellar lobe (t = 3.852, P < 0.05). Conclusions There are distinctive cerebral perfusion patterns in PD and ET patients, which implies that these two conditions may be associated with distinct pathophysiological mechanisms.

Functional tics is one type of functional movement disorders (FMD) with overlapping clinical manifestations of primary tics. It is difficult to distinguish them in clinical practice. In this text, we will introduce the epidemiology, risk factors, clinical features, diagnosis and treatment of functional tics by comparing with primary tics (especially Tourette's syndrome), with the aim to improve the rate of accurate diagnosis, and avoid misdiagnosis and mistreatment.

Psychogenic nonepileptic seizure (PNES) is a common functional neurological disorder with complex neuropsychiatric etiology and clinical characteristics. Its diagnosis is mainly based on medical history and symptomatology, which is easily to misdiagnosis in clinical practice. Pay attention to distinguish it from epilepsy, and reduce or completely eliminate seizures. This review introduces the latest advances from four aspects: clinical manifestations, diagnosis, differential diagnosis, and treatment of PNES, to help clinicians diagnose and treat PNES effectively in clinical practice, improving patients' life quality.

Functional tremor (FT) is the most common manifestation of functional movement disorder (FMD), but its clinical recognition is insufficient, and there is no clear diagnostic standard and effective treatment method at present. The diagnosis mainly depends on the medical history, clinical examination, physical signs, neuroelectrophysiological examinations. Early diagnosis and treatment are essential to improve the prognosis of the patients. The etiology and pathogenesis of FT have not been clarified. This article reviews the progress in diagnosis and treatment of FT in order to improve the clinicians' understanding of the disease and provide the possibility for treatment.

Functional movement disorder (FMD) is a common conversion disorder, and those who involve the face are called functional facial disorders. It seriously affects patients' social contact and work. Most clinicians have insufficient understanding of functional facial disorders, resulting in delayed diagnosis and treatment. This paper reviews the clinical features, electrophysiology, diagnosis and differential diagnosis, and treatment of functional facial disorders to improve the level of diagnosis and treatment.

Functional neurological disorder (FND) is a disorder of the autonomic motor or sensory system with well⁃defined symptoms, which covers functional movement disorder, psychogenic non⁃epileptic seizures, functional sensory disorder, functional cognitive disorder, persistent postural perceptual dizziness and so on. Its complex and diverse characteristics make the diagnosis and treatment of the disease and research difficult, so FND has long been a "gray area", but its high incidence, disability rate and high consumption of medical resources remind us that FND cannot be ignored. This paper reviews the current clinical classification of FND and the diagnostic criteria in order to improve the diagnosis and treatment by domestic colleagues.

Functional neurological disorder (FND) was first described by ancient Egyptians. Meanwhile, traditional Chinese medicine has long recognized this kind of disease, and it was classified into the categories of depression syndrome, hysteria, lily disease, mania, epilepsy, and so on. Throughout the understanding and research process of FND, we have experienced the iteration of terms such as "hysteria", "conversion/dissociative disorder", "psychogenic neurological disease", and "functional neurological disorder", which reflected the tight development of the cross connection between neurology and psychiatry. Since Pierre Briquet described hysteria as somatization disorder in 1859, FND have developed for nearly 150 years, representing the history of modern neuropsychology and psychology combined exploration. This article aims to systematically review the history of FND, look forward to their diagnositc and therapeutic models and prospects.

Functional neurological disorder (FND) is a kind of autonomic motor or sensory system disease with well⁃defined clinical symptoms. It has attracted the attention of many scientists due to its high incidence and heavy social burden, and many studies have promoted the development of FND. However, due to the late start of related research in China, clinicians, patients and their families have relatively weak understanding of the concept of FND and related knowledge. This article analyzes the current status of FND diagnosis and treatment in China, proposed the suggestions to improve the level of diagnosis and treatment for FND in details and enhance related study.

Functional tremor (FT) is the most common manifestation of functional movement disorder (FMD), but its clinical recognition is insufficient, and there is no clear diagnostic standard and effective treatment method at present. The diagnosis mainly depends on the medical history, clinical examination, physical signs, neuroelectrophysiological examinations. Early diagnosis and treatment are essential to improve the prognosis of the patients. The etiology and pathogenesis of FT have not been clarified. This article reviews the progress in diagnosis and treatment of FT in order to improve the clinicians' understanding of the disease and provide the possibility for treatment. [ABSTRACT FROM AUTHOR]

This paper aims to explore the main points of diagnosis， treatment and misdiagnosis of conversion disorder characterized by paroxysmal abdominal pain. The general hospitals had a high misdiagnose rate and no effective symptomatic treatment for conversion disorder patients with physical discomfort as main symptoms， which leading to heavy physical and mental burden of patients and waste of medical resources， so this paper retrospectively analyzed the etiology， diagnostic process， treatment and therapeutic effect of a case of conversion disorder with paroxysmal abdominal pain as the main symptom. Case analysis showed that the physical discomfort as chief complain of conversion disorder patients affected the rate of early correct diagnosis and treatment， so clinicians' ability of diagnosis and differential diagnosis of conversion disorder needs to be strengthened. At the same time， cognitive behavioral therapy （CBT） is effective in the clinical treatment and recurrence prevention of conversion disorder.