Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Acta Neurol Belg. 2021 Jun;121(3):643-647. doi: 10.1007/s13760-021-01660-y. Epub 2021 Mar 27.
The concept of functional movement disorders has evolved considerably over the past few decades. More specifically, the views on the relation with psychological stressors or personality disorders have substantially changed, emphasizing a shift from the previously dominant dualistic scheme. This evolution is reflected in adaptations to diagnostic criteria and management approaches. Functional movement disorders which arise in a close temporal relationship with a peripheral trauma are specifically challenging with respect to diagnosis and treatment, but similar considerations seem to apply. The relationship of functional disorders with trauma appears to be much closer than is often thought. Clinical and pathophysiological research has identified shared factors underlying functional posttraumatic as well as primary movement disorders. These evolving insights impact on discussions in terms of litigation for compensation after trauma. The literature is reviewed and the consequences for argumentation in litigation are outlined, including ethical and legal considerations. Finally, we formulate a number of recommendations.
功能性运动障碍的概念在过去几十年中发生了很大的变化。更具体地说，人们对其与心理应激源或人格障碍关系的看法发生了实质性的改变，强调了从以前占主导地位的二元论模式的转变。这种演变反映在诊断标准和治疗方法的适应性上。与外周创伤密切相关的功能性运动障碍在诊断和治疗方面特别具有挑战性，但类似的考虑似乎也适用。功能性障碍与创伤之间的关系比人们通常认为的要密切得多。临床和病理生理学研究已经确定了功能性创伤后和原发性运动障碍的共同因素。这些不断发展的认识影响了创伤后赔偿诉讼中的讨论。我们回顾了相关文献，并概述了诉讼论证的后果，包括伦理和法律方面的考虑。最后，我们提出了一些建议。
