Psychogenic Movement Disorders and Other Conversion Disorders

by Hallett, Mark; Lang, Anthony E., M.D.; Jankovic, Joseph; Fahn, Stanley; Halligan, Peter W.

• ISBN13: 9781107007345
• ISBN10: 1107007348
• Edition: DVD
• Format: Hardcover
• Copyright: 2012-01-31
• Publisher: Cambridge Univ Pr

Summary

Conversion is very common but often misdiagnosed; even when diagnosed, treatment is difficult. It is critical for physicians to have the necessary knowledge to manage these patients in the most effective way. This volume gives all of the available, up-to-date information on when to think about conversion in movement disorders, how to make a diagnosis, how to use the laboratory to support a clinical diagnosis and how to develop a therapeutic plan. Written by experts in neurology, psychiatry, psychology, neuroimaging, neurophysiology and genetics, this book covers psychogenic movement disorders and other conversion disorders from all of the most relevant clinical angles. An accompanying CD-ROM with a video library featuring over 100 real-life examples of movement disorders will aid diagnosis. Neurologists and psychiatrists, as well as others interested in brain pathophysiology at the boundary of neurology and psychiatry, will find this a useful aid to both clinical practice and research.

Author Biography

Mark Hallett, MD is Chief of the Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, Bethesda, MD, USA. Anthony E. Lang, MD, FRCPC is Professor and Director of the Division of Neurology, and Jack Clark Chair for Parkinson's Disease Research, University of Toronto, and Director of the Movement Disorders Center, Toronto Western Hospital, ON, Canada. Joseph Jankovic, MD is Professor of Neurology, Distinguished Chair in Movement Disorders and Director of the Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Department of Neurology, Houston, TX, USA. Stanley Fahn, MD is H. Houston Merritt Professor of Neurology and Director of the Center for Parkinson's Disease and Other Movement Disorders, Columbia University, New York, NY, USA. Peter W. Halligan DSc, FBPS, FMedSci is Professor and Dean of Strategic Futures and Interdisciplinary Studies, School of Psychology, Cardiff University, UK. Valerie Voon, MD is a Clinical Research Associate in the Behavioural and Clinical Neuroscience Institute, Department of Psychiatry, University of Cambridge, UK. C. Robert Cloninger, MD is Wallace Renard Professor of Psychiatry and Director of the Center for Psychobiology of Personality, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.

Table of Contents

List of contributors	p. vii
Preface	p. xi
Clinical issues
Introduction to the psychiatry of conversion disorders	p. 1
Phenomenology of psychogenic movement disorders	p. 6
Psychogenic parkinsonism	p. 14
Epidemiology and clinical impact of psychogenic movement disorders	p. 20
The Scottish Neurological Symptoms Study: diagnoses, characteristics, and prognosis in 1144 new neurology outpatients with symptoms unexplained by disease	p. 30
Predisposition and issues of mixed etiology in psychogenic movement disorders	p. 33
Psychogenic movement disorders in children	p. 38
Childhood disorders: another perspective	p. 56
Clinical features and treatment outcome of conversion disorders in children and adolescents	p. 59
Somatoform disorders and psychogenic movement disorders	p. 63
Psychogenic non-epileptic seizures	p. 71
Hypochondriasis and its relationship to somatization	p. 83
Movement disorders in complex regional pain syndrome: the pain field perspective	p. 89
Psychogenic dystonia in psychogenic complex regional pain syndrome	p. 96
Latah and related syndromes	p. 103
Trauma and dissociation: clinical manifestations, diagnosis, epidemiology, pathogenesis, and treatment	p. 106
Psychogenic movement disorders: illness in search of disease?	p. 120
Possible genetic approaches to conversion	p. 134
Physiology
Functional brain imaging of psychogenic paralysis during conversion and hypnosis	p. 143
Action control in conversion paralysis: evidence from motor imagery	p. 160
Imaging in psychogenic movement disorders	p. 168
Imaging in hysterical, hypnotically suggested, and malingered limb paralysis	p. 173
Functional imaging of psychogenic and feigned weakness	p. 180
An fMRI study of recall of causal life events in conversion disorder: preliminary evidence of increased orbitofrontal and parietal activation	p. 184
Cortisol, trauma, and threat vigilance in patients with psychogenic non-epileptic seizures	p. 187
Components of voluntary action	p. 189
Action selection in psychogenic movement disorders	p. 196
Insights from physiology: tremor and myoclonus	p. 199
Physiology of psychogenic dystonia	p. 205
Evoked potentials in the assessment of patients with suspected psychogenic sensory symptoms	p. 209
Characterizing and assessing the spectrum of volition in psychogenic movement disorders	p. 217
Assessment
Rating scales for psychogenic movement disorders	p. 225
Quality of life in psychogenic disorders: the cause, not the effect	p. 231
Psychiatric testing	p. 235
Diagnostic considerations for the assessment of malingering within the context of psychogenic movement disorders	p. 240
Treatment
Prognosis in patients with psychogenic motor disorders	p. 249
Psychogenic movement disorders: explaining the diagnosis	p. 254
Patterns of practice: report of the Movement Disorder Society questionnaire	p. 267
Psychotherapy for psychogenic movement disorders	p. 275
Pharmacotherapy	p. 284
Suggestion	p. 289
Treating psychogenic movement disorders with suggestion	p. 295
Inpatient therapy: trying to transcend pathological dissociation, dependence, and disability	p. 302
Appendix: Psychogenic movement disorders video legends	p. 310
Index	p. 319
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