An Update on Functional (Psychogenic) Tremor

Abstract

Functional tremor accounts for at least 50% of patients with functional movement disorders. The diagnostic work-up of these patients can be challenging. It is a multistep process based on patients’ history and clinical criteria finally providing a ‘positive’ diagnosis. Variability of the tremor over the disease course and during clinical examination is characteristic. Patients often show increased attention toward the tremulous body part and distractability of the tremor once attention is drawn away. Sometimes distractability becomes obvious during history taking or neurological examination, in others certain distraction tasks are needed. If uncertainty remains, ancillary investigations such as electrophysiological tests may be helpful. Recent studies suggested that a loss of sense of control of ones actions may help to explain why patients with functional tremor report that they do not experience the abnormal movement as voluntary. Treatment has to be placed in a multidisciplinary team involving neurologists, psychiatrists, physiotherapists and psychologists.

KEYWORDS:

• distractability
• electrophysiological test battery
• functional movement disorders
• functional tremor
• multidisciplinary treatment
• positive clinical criteria
• psychogenic tremor

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.