Psychogenic movement disorders: functional

neurologic impairment?
Miguel Nascimento, Pedro Brs, Filomena Bacelar, Helena guas, Alice
Nobre, Rui Pedrosa
Objectives: Psychogenic movement disorders (PMD) are relatively
common in Neurologic and Psychiatric wards. ICD-10 considers as a
dissociative disorder, as DSM-5 differentiates as a somatoform disorder,
while recognizing that relevant psychological factors may not be
demonstrable at the time of diagnosis. The authors aim to discuss the
relevance of psychological factors, as well as co-morbid personality
traits/disorders.
.
Methods: We present the case of a 36 year old female, hospitalized in
Neurology for dizziness, involuntary movements three days prior
admittance. History of depressive episode with suicidal attempt (quit
psychiatric consults). Neurologic exam only showed abasia-astasia, (though
it was never observed any fall); involuntary movements of the head and
arms, which resolved while seated or lying on her bed; and were less
intense when distracted. All exams showed no alterations. Psychiatric
evaluation showed low self-awareness for multiple recent life events,
difficult relationship with her relatives, low insight of her condition.
Diagnostic of Borderline Personality disorder was considered for this
patient.
Results: PMD

Conclusions: While sometimes difficult to consider personality traits

during neurologic evaluation, they seem quite relevant to be considered
while observing a patient with PMD, even though theyre no longer part of
the diagnostic criteria.
References