Objective: Our study aims to report the frequency of patients with FMD and to describe their demographic and clinical data. The second aim of our study was to demonstrate the relationship of demographic and clinical variables in “pure FMD patients” and “patients with organic movement disorders (OMD) in addition to FMD.”

Background: Functional movement disorders (FMDs) are clinical syndromes that are defined by the appearance of abnormal, involuntary movements not associated with a known neurological cause and can be significantly suppressed by distraction or non-physiological maneuvers during neurological examinations.

Method: Patients who were admitted to Mersin University Medical Faculty Hospital, Department of Neurology Movement Disorder Outpatient Clinic between 9/15/2016 and 3/15/2021 were evaluated prospectively using the “non-motor symptoms scale” and the FMD diagnostic criteria defined by Gupta and Lang. Demographic and clinical data of the patients were analyzed using a semi- structured scale. The prospective study design ensured standard data collection from all patients.

Results: The prevalence of “clinically defined” FMD in our Movement Disorder Outpatient Clinic was 5.59% (71% female, mean ± standard deviation [SD] age = 49.08 ± 16.22). Education level in FMD was higher than the general population. The most common clinical presentations of FMD were functional tremor (36%) and dystonia (34%). “Rapid progression to maximum severity and disability” (80%), “distractibility” (80%), and “prominence during examination” (77%) are the most frequently observed clinical signs in patients with FMD. 70% of the patients with FMD have at least one neurological comorbidity (OMD in 36%) and 75% have psychiatric comorbidities. Depressive mood (70%), weakness-fatigue (63%), and insomnia
(55%) are the most common non-motor symptoms of FMD. The mean age (Mean ± SD = 57.58 ± 15.96) and cognitive impairment were higher in the FMD + OMD group compared to the pure FMD patient group due to the nature of the neurodegenerative diseases. Suicidal tendencies and substance use were recorded in 15% and 5% of FMDs, respectively.

Conclusion: Delayed diagnosis of FMD can lead to unnecessary and costly examinations and reinforcement of the “patient” role which has a negative impact on quality of life and work life.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/epidemiology-of-functional-movement-disorders/