title: Neurologic diagnostic criteria for functional neurologic disorders.
abstract: The diagnosis of functional neurologic disorders can be challenging. In this chapter we review the diagnostic criteria and rating scales reported for functional/psychogenic sensorimotor disturbances, psychogenic nonepileptic seizures (PNES) and functional movement disorders (FMD). A recently published scale for sensorimotor signs has some limitations, but may help in the diagnosis, and four motor and two sensory signs have been reported as highly reliable. There is good evidence using eight specific signs for the differentiation of PNES from seizures. Recently, diagnostic criteria were developed for PNES; their sensitivity and specificity need to be evaluated. The definitive diagnosis of PNES can be made by recording typical positive features during the spells, and in a low proportion of cases, where the distinction with an organic etiology cannot easily be done, a normal electroencephalogram suggests the diagnosis. FMD diagnosis relies on diagnostic criteria, which have been refined over time and may be supplemented by laboratory tests in some phenotypes. Rating scales for PNES and FMD could be useful for severity measures, but several limitations remain to be addressed.
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada; HM CINAC-Hospital Universitario HM Puerta del Sur, Móstoles, Universidad CEU San Pablo, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Gasca-Salas
authors.affiliation: Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, University Health Network, Toronto Western Hospital, Toronto, Ontario, Canada. Electronic address: lang@uhnres.utoronto.ca.
authors.forename: A E
authors.initials: AE
authors.lastname: Lang
mesh_terms: D003291:Conversion Disorder / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D009069:Movement Disorders / Q000175:diagnosis* / Q000523:psychology*; D011602:Psychophysiologic Disorders / Q000175:diagnosis; D012640:Seizures / Q000175:diagnosis* / Q000523:psychology*
keywords: certainty; diagnostic criteria; functional; movement disorders; neurologic disorders; nonepileptic seizures; psychogenic; rating scales; reliability; sensorimotor disturbances