Psychogenic Movement Disorders and Other Conversion Disorders

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. Features • Accompanying CD-ROM with videos of a large number of patients with psychogenic movement disorders helps users in making diagnoses • Case studies are presented in context providing practical, real life guidance for diagnosis and treatment • Sheds light on the previously mysterious pathophysiology, giving readers the necessary foundation for treatment Table of Contents Preface Part I. Clinical Issues: 1. Introduction to the psychiatry of conversion disorders 2. Phenomenology of psychogenic movement disorders 3. Psychogenic parkinsonism 4. Epidemiology and clinical impact of psychogenic movement disorders 5. The Scottish neurological symptoms study: diagnosis and prognosis in 1144 new neurology outpatients with symptoms unexplained by disease 6. Predisposition and issues of mixed etiology in psychogenic movement disorders 7. Psychogenic movement disorders in children 8. Childhood disorders: another perspective 9. Clinical features and treatment outcome of conversion disorders in children and adolescents 10. Somatoform disorders and psychogenic movement disorders 11. Psychogenic non-epileptic seizures 12. Hypochondriasis and its relationship to somatization 13. Movement disorders in complex regional pain syndrome – the pain field perspective 14. Psychogenic dystonia in psychogenic complex regional pain syndrome 15. Latah and related syndromes 16. Trauma and dissociation: clinical manifestations epidemiology, pathogenesis and treatment 17. Psychogenic movement disorders: illness in search of disease? 18. Possible genetic approaches to conversion Part II. Physiology: 19. Functional brain imaging of psychogenic paralysis during conversion and hypnosis 20. Action control in conversion paralysis: evidence from motor imagery 21. Imaging in psychogenic movement disorders 22. Imaging: hysterical, hypnotically suggested and malingered limb paralysis 23. Functional imaging of psychogenic and feigned weakness 24. An fMRI study of recall of causal life-events in conversion disorder: preliminary evidence of increased orbito-frontal and parietal activation 25. Cortisol, trauma and threat vigilance in patients with psychogenic non-epileptic seizures 26. Components of voluntary action 27. Action selection in psychogenic movement disorders 28. Insights from physiology: tremor and myoclonus 29. Physiology of psychogenic dystonia 30. Evoked potentials in the assessment of patients with suspected psychogenic sensory symptoms 31. Characterizing and assessing the spectrum of volition in psychogenic movement disorders Part III. Assessment: 32. Rating scales for psychogenic movement disorders 33. Quality of life in psychogenic movement disorders: the cause not the effect 34. Psychiatric testing 35. Diagnostic considerations for the assessment of malingering within the context of psychogenic movement disorders Part IV. Treatment: 36. Prognosis in patients with psychogenic movement disorders 37. Presenting the diagnosis 38. Patterns of practice [MDS Questionnaire report] 39. Psychotherapy for psychogenic movement disorders 40. Pharmacotherapy 41. Suggestion 42. Treating psychogenic movement disorders with suggestion 43. In-patient therapy: trying to transcend pathological dissociation, dependence and disability 44. Appendix: psychogenic movement disorders, video legends Index.