Diagnosis and Treatment of Functional (Psychogenic) Parkinsonism

Seminars in Neurology
Kathrin LaFaver, Alberto J Espay

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.

Citations

Sep 12, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Franziska Hopfner, Günther Deuschl
Dec 11, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Michele TinazziFrancesca Morgante
Nov 10, 2020·Movement Disorders Clinical Practice·Michele TinazziChristian Geroin
Nov 10, 2020·CNS Spectrums·Sarah C LidstoneAnthony E Lang
Mar 22, 2021·Brain : a Journal of Neurology·Sanskriti Sasikumar, Antonio P Strafella
Oct 14, 2019·Revue neurologique·S GalliS Aybek

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