title: Cranial functional (psychogenic) movement disorders.
abstract: Functional (psychogenic) neurological symptoms are frequently encountered in neurological practice. Cranial movement disorders--affecting the eyes, face, jaw, tongue, or palate--are an under-recognised feature of patients with functional symptoms. They can present in isolation or in the context of other functional symptoms; in particular, for functional eye movements, positive clinical signs such as convergence spasms can be triggered by the clinical examination. Although the specialty of functional neurological disorders has expanded, appreciation of cranial functional movement disorders is still insufficient. Identification of the positive features of cranial functional movement disorders such as convergence and unilateral platysmal spasm might lend diagnostic weight to a suspected functional neurological disorder. Understanding of the differential diagnosis, which is broad and includes many organic causes (eg, stroke), is essential to make an early and accurate diagnosis to prevent complications and initiate appropriate management. Increased understanding of these disorders is also crucial to drive clinical trials and studies of individually tailored therapies.
authors.affiliation: Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK; Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, UK. Electronic address: d.kaski@imperial.ac.uk.
authors.forename: Diego
authors.initials: D
authors.lastname: Kaski
authors.affiliation: Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK; Division of Brain Sciences, Imperial College London, Charing Cross Hospital, London, UK.
authors.forename: Adolfo M
authors.initials: AM
authors.lastname: Bronstein
authors.affiliation: Department of Neuro-otology, National Hospital for Neurology and Neurosurgery, London, UK; Sobell Department of Motor Neuroscience and Movement, UCL Institute of Neurology, London, UK.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Edwards
authors.affiliation: Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Stone
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D009069:Movement Disorders / Q000175:diagnosis* / Q000503:physiopathology; D009460:Neurologic Examination