Diagnosis and Treatment of Functional (Psychogenic) Parkinsonism

Kathrin LaFaver*, Alberto J. Espay

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Functional (psychogenic) parkinsonism (FP) is recognized by the mandatory combination of marked slowness without progressive decrement on repetitive manual tasks and variable resistance against passive movements in the absence of cogwheel rigidity. Other functional phenotypes, such as functional tremor and functional gait impairment, may coexist. Although neither necessary nor sufficient for the diagnosis of FP, supportive historical clues include the sudden onset of symptoms and absent or nonphysiologic response to levodopa. In selected cases where examination features remain insufficient to render a clinically definite FP diagnosis, normal dopaminergic transporter imaging (DAT scan) confirms laboratory supported FP. The management of FP begins with diagnostic debriefing, as the full acceptance of the diagnosis is critical in ensuring patient involvement in individualized psychoeducation, psychotherapy, and physical and occupational therapy.

Original languageEnglish (US)
Pages (from-to)228-232
Number of pages5
JournalSeminars in Neurology
Volume37
Issue number2
DOIs
StatePublished - Apr 1 2017

Keywords

  • DAT scan
  • functional movement disorders
  • functional parkinsonism
  • psychogenic movement disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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