Kompoliti calls “hardware” problems, functional movement disorders are more akin to problems with “software.” “When someone has a stroke, you can see where the hardware is damaged.
“What we need to convey to patients is that functional movement disorders are not ‘in their head,’ but are, in fact, in their brain.” However, rather than being what Dr. “Patients usually need positive answers and want to know what’s wrong with them, instead, patients are often left with the notion that their problems are all in their head,” says Dr. Kompoliti, the unique challenges of understanding functional movement disorders has increased the burden of disease for patients who often feel like physicians don’t know what to do with them. While the shift away from a diagnosis of exclusion to a diagnosis of inclusion is better in the long-term, it may present unique difficulties for physicians who might not feel comfortable making the judgment call on a positive diagnosis. Additionally, re-assure patients that this is not a disorder that’s “in their head,” but is instead in their brain.
#FUNCTIONAL MOVEMENT DISORDER HOW TO#
When speaking to patients about their movement disorders, emphasize that why they have the disorder is much less important than how to address it. “Whereas previous DSM codes focused on the ‘medically unexplained’ aspects of functional movement disorders, the new guidelines in DSM-V emphasize the degree to which the patient’s thoughts, feelings and behaviors about their somatic symptoms are disproportionate or excessive,” says Dr. More recently, she notes, attitudes from leaders in the field have begun to shift in favor of a more positive diagnosis, as reflected in the new round of diagnostic codes. “We often have to rule out what we used to call ‘organic disease’ before we arrive at the diagnosis of functional movement disorders.” The basic notion was that there is nothing medically wrong with patients with functional movement disorders, which is why they were defined by what they were not.
“Historically, the diagnosis of a functional movement disorder has been one of exclusion rather than inclusion,” she says. While most patients with functional movement disorders share a similar symptomatic profile, rendering easy recognition in many cases, diagnosis is more complicated, according to Dr. What are the challenges of recognizing and diagnosing functional movement disorders? She also offers insight on how specialists from neurology, the psychiatry/psychology disciplines, as well as rehabilitation specialists, can interface better for the improved care of patients. Kompoliti shares strategies for communicating with patients with functional movement disorders. According to Katie Kompoliti, MD, Professor of Neurology and Director of the Movement Disorders Fellowship Program at Rush University in Chicago, patients with functional movement disorders often easily fall between the cracks of the two disciplines and do not receive the care they require. Functional movement disorders represent one of those intersection points, illustrating unique challenges as well as opportunities for care. Though separate scientific disciplines, neurology and psychiatry frequently cross paths and require both expertise and care from physicians of varying backgrounds.
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