Neurol. praxi. 2013;14(4):182-184

Psychogenic disorders of gait

prof.MUDr.Evžen Růžička, DrSc., MUDr.Tereza Serranová, Ph.D.

Neurologická klinika a Centrum klinických neurověd, 1. LF UK a VFN v Praze

Gait disturbances are ranked among the most common manifestations of psychogenic movement disorders, a nosological area lying

between neurology and psychiatry where both physicians and patients often find themselves at risk of diagnostic and therapeutic

errors. The aim of this review is to show the typical manifestations, emphasize diagnostic principles and outline the therapeutic options

for psychogenic movement disorders, with a special focus on disorders of gait. Typical patterns of psychogenic gait disorders include

1. balance disorders (with inadequately broad-based gait, often with paradoxical improvements in tandem walking test, spontaneous

rope-walkers gait or astasia-abasia), 2. pseudoparetic gait or 3. extremely slow gait. At the same time, expressed are general features of

psychogenic movement disorders such as inconsistency of symptoms over time, incongruence with typical organic movement disorders,

high energy expenditure and characteristic changes in symptoms with distracted attention. The diagnosis of psychogenic movement

disorders is clinical and on full responsibility of the neurologist, who should not repeat the negative auxiliary examinations to „exclude

organicity“ or expect that another specialist will make the diagnosis and communicate it to the patient. Success of the treatment regimen

for psychogenic movement disorders decreases with their duration and with development of their social consequences.

Keywords: movement disorders, psychogenic, functional disorders

Published: October 1, 2013  Show citation