Beyond Functional Movements: The Spectrum of Functional Neurological and Somatic Symptoms

Abstract

Motor symptoms including tremor, gait difficulties, dystonia, jerks and limb weakness are core neurological presentations in the phenotype of functional movement disorder. However, many patients present with mixed symptoms, including experiencing other functional neurological symptoms (e.g., functional [psychogenic nonepileptic/dissociative] seizures) and/or distressing comorbid physical symptoms (e.g., pain and fatigue). This chapter reviews a range of other functional neurological symptoms including functional seizures, sensory deficits, cognitive symptoms, and persistent postural perceptual dizziness. Other commonly present bodily symptoms including pain and fatigue are discussed, as well as the potential presence of health anxiety. In developing a patient-centered treatment plan, in addition to triaging the functional movement disorder phenotype, a range of other functional neurological symptoms, somatic symptoms and related health anxiety should also be considered.KeywordsFunctional movement disorderFunctional neurological disorderFunctional seizuresPsychogenic nonepileptic seizuresPain, fatigue