Cross-cultural influences on psychogenic movement disorders - A comparative review with a Brazilian series of 83 cases

Objective: To describe the profile and presentation of a Brazilian series of psychogenic movement disorders (PMD) patients and to perform a comparative analysis with the previous series published worldwide. Methods: A total of 83 patients with a clinical diagnosis of PMD were included. All patients were assessed and followed at the Movement Disorders Outpatient clinic from 2000 to 2008. Demographic, clinical, paraclinical, and treatment outcome data were collected using a standardized protocol. The Gupta & Lang criteria were used for the diagnosis of PMD. Results: Seventy-three patients were females (87.95%), with mean age of onset of 39 +/- 5.1 years. Tremor was the most frequent PMD, occurring in 42(50.6%) patients followed by dystonia, in 27(32.5%) patients. Cerebellar-like ataxia was seen in 3 patients (4.16%). Psychiatric co-morbidities were diagnosed in 67 (80.7%) of the patients. Thirty-five of the 58 patients (60.3%) who were managed and followed up for six months had some degree of improvement, including 22 patients (37.9%) with complete or almost complete remission. Conclusion: In this series of patients with PMD, tremor and dystoria were most frequent PMD. Our results overlap those of the literature regarding most demographic and clinical findings, demonstrating the trans-cultural aspect of PMD. (C) 2010 Elsevier B.V. All rights reserved.