title: Transcranial magnetic stimulation as an efficient treatment for psychogenic movement disorders.
abstract: BACKGROUND
  Management of psychogenic movement disorders (PMDs) is challenging for neurologists and, to date, there is no consensus about their treatment. Recent studies suggested a possible therapeutic effect of repeated transcranial magnetic stimulation (TMS) in psychogenic paralysis and tremor.
  
  
  OBJECTIVE
  To document the clinical impact of TMS in PMDs.
  
  
  METHODS
  We blindly video scored symptoms of consecutive patients with PMD who were recorded before and after TMS. TMS was delivered at low frequency (0.25 Hz) over the motor cortex contralateral to symptoms.
  
  
  RESULTS
  Twenty-four patients were included. They presented with dystonia, myoclonus, tremor, Parkinsonism or stereotypies. The median duration of symptoms before TMS was 2.8 years (6 months to 30 years). The overall score of 75% of patients improved by >50% and, furthermore, the clinical benefits were sustained upon protracted follow-up (median 19.8 months). There was no correlation between improvement and duration of symptoms before TMS.
  
  
  CONCLUSIONS
  TMS is a therapeutic option for PMDs, including chronic PMDs.
authors: Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre de Référence Maladie de Parkinson, APHP, Paris, France.
authors: Béatrice
authors: B
authors: Garcin
authors: Emmanuel
authors: E
authors: Roze
authors: Francine
authors: F
authors: Mesrati
authors: Emmanuel
authors: E
authors: Cognat
authors: Emmanuel
authors: E
authors: Fournier
authors: Marie
authors: M
authors: Vidailhet
authors: Bertrand
authors: B
authors: Degos
mesh_terms: D000328:Adult; D000368:Aged; D003291:Conversion Disorder / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D004421:Dystonia / Q000175:diagnosis; D004569:Electroencephalography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D009207:Myoclonus / Q000175:diagnosis; D020734:Parkinsonian Disorders / Q000175:diagnosis; D010865:Pilot Projects; D011446:Prospective Studies; D012008:Recurrence; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014202:Tremor / Q000175:diagnosis; D055815:Young Adult
keywords: Dystonia; Hysteria; Myoclonus; Tremor