Diagnostik und Therapie funktioneller neurologischer Bewegungsstörungen

Functional movement disorders are frequent diseases characterized by heterogeneous disorders of voluntary motor function and non-motor symptoms. However, the diagnostics and appropriate further care are often associated with uncertainty among patients and treating physicians. To facilitate the diagnostic process, this article explains the approach to medical history taking and the clinical examination. The focus is on the inconsistency and incongruence of symptoms as well as the patient-orientated communication of the diagnosis, which is the first step in treatment. Further therapeutic measures should be orientated towards the individual needs of the patient and based on psychoeducation and the development of a mutual disease model. Both psychotherapy and physiotherapy are recommended for treatment and are best combined as part of integrative approaches. Given the high frequency of the disorder and the fact that making the diagnosis, treatment planning and coordination are the domain of neurology, functional disorders are by no means a peripheral matter but should be perceived and treated as a genuine neurological phenomenon.