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Abstract

We report 18 patients (13 women, 5 men; age range, 22 to 75 years; mean, 42.5), whom we ultimately diagnosed as having “psychogenic myoclonus.” The myoclonus was present for an average of 36 months (range, 1 to 110), and it was segmental in 10, generalized in seven, and focal in one. Stress precipitated or exacerbated the myoclonic movements in 15 patients; 14 had a definite increase in myoclonic activity during periods of anxiety. A combination of the following findings helped to establish the psychogenic nature of the myoclonus: (1) clinical features incongruous with “organic” myoclonus, (2) evidence of underlying psychopathology, (3) an improvement with distraction in 14 and with placebo in nine, and (4) the presence of incongruous sensory loss or false weakness in five. Over half of all patients with adequate follow-up improved after gaining insight into the psychogenic mechanisms of their movement disorder. This study attempts to characterize psychogenic myoclonus, the most common psychogenic movement disorder in our movement disorders clinic, and provides a guide to its diagnosis and treatment.

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Published In

Neurology®
Volume 43Number 2February 1993
Pages: 349
PubMed: 8437701

Publication History

Published online: February 1, 1993
Published in print: February 1993

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Affiliations & Disclosures

Kim Monday, MD
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX.
Joseph Jankovic, MD
Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX.

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Cited By
  1. Functional tic-like presentations differ strikingly from Provisional Tic Disorder, F1000Research, 11, (1566), (2023).https://doi.org/10.12688/f1000research.129252.2
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  2. Diagnosis and Management of Functional Tic-Like Phenomena, Journal of Clinical Medicine, 11, 21, (6470), (2022).https://doi.org/10.3390/jcm11216470
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  3. Functional tic-like presentations differ strikingly from Provisional Tic Disorder, F1000Research, 11, (1566), (2022).https://doi.org/10.12688/f1000research.129252.1
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  4. Psychogenic Tics: Diagnostic Value of the Placebo Test, Journal of Child Neurology, 19, 12, (976-977), (2022).https://doi.org/10.1177/088307380401901201
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  5. Diagnosis and Initial Treatment of Functional Movement Disorders in Children, Seminars in Pediatric Neurology, 41, (100953), (2022).https://doi.org/10.1016/j.spen.2022.100953
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  6. Functional Movement Disorders, Movement Disorders in Childhood, (667-679), (2022).https://doi.org/10.1016/B978-0-12-820552-5.00023-1
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  7. Motor Assessments, Movement Disorders in Childhood, (69-81), (2022).https://doi.org/10.1016/B978-0-12-820552-5.00014-0
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  8. Functional Jerky Movements, Functional Movement Disorder, (103-113), (2022).https://doi.org/10.1007/978-3-030-86495-8_9
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  9. Functional Facial Disorders, Functional Movement Disorder, (115-134), (2022).https://doi.org/10.1007/978-3-030-86495-8_10
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  10. Functional (psychogenic) movement disorders, Principles and Practice of Movement Disorders, (593-607.e4), (2021).https://doi.org/10.1016/B978-0-323-31071-0.00027-5
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