Mendoza-Rodríguez A, Riveira-Rodríguez C, Castrillo-Sanz A
Sección de Neurología, Hospital General de Segovia, Ctra. Ávila, s/n. E-40002 Segovia.
Rev Neurol. 2009 Jan 23;48 Suppl 1:S49-55.
Psychogenic movement disorders are movement disorders that cannot be attributed to any known organic disease and which are caused by an underlying psychiatric pathology or are due to voluntary simulation. They account for 1-3% of all movement disorders.
To review the literature and to update our knowledge on psychogenic movement disorders.
We review different aspects of psychogenic movement disorders, including their epidemiology, clinical diagnosis and diagnosis by means of complementary tests, types of psychogenic movement disorders, their treatment and prognosis. Psychogenic movement disorders must be diagnosed by a neurologist and it must not be simply a diagnosis of exclusion. The most frequent presenting symptom is tremor and this where most progress has been made, above all in the contributions made by neurophysiological tests to the diagnosis. Few studies have been conducted on specific treatment. It is necessary to treat the underlying psychiatric pathology, and psychotherapy in association with drugs is recommended if needed. The prognosis of psychogenic movement disorders continues to be insufficient, even with suitable treatment.
Although in recent years some progress has been made in our knowledge of psychogenic movement disorders, more research is needed to determine the mechanism underlying these pathologies, as well as the techniques and complementary tests that can help reach a diagnosis. Further studies on treatment are also required.
心理性运动障碍是指不能归因于任何已知器质性疾病的运动障碍，其由潜在的精神病理学引起或源于自愿伪装。它们占所有运动障碍的1%至3%。
回顾文献并更新我们对心理性运动障碍的认识。
我们回顾了心理性运动障碍的不同方面，包括其流行病学、临床诊断以及通过辅助检查进行的诊断、心理性运动障碍的类型、治疗和预后。心理性运动障碍必须由神经科医生进行诊断，而不能仅仅是排除性诊断。最常见的首发症状是震颤，在这方面取得了最大进展，尤其是神经生理学检查对诊断的贡献。针对具体治疗的研究很少。有必要治疗潜在的精神病理学问题，如有需要，建议将心理治疗与药物治疗相结合。即使进行了适当治疗，心理性运动障碍的预后仍然不尽人意。
尽管近年来我们对心理性运动障碍的认识取得了一些进展，但仍需要更多研究来确定这些病症的潜在机制，以及有助于做出诊断的技术和辅助检查。还需要对治疗进行进一步研究。
