Functional Movement Disorder in Children

Functional neurologic disorder in children frequently manifests as an acute-onset movement disorder, most often presenting with abnormal gait, myoclonus, dystonia, tremor, or a combination of these symptoms. In fact, functional movement disorder (FMD) presentations comprise a quarter of acute-onset movement disorders. FMD may complicate pre-existing neurological disorders (e.g., functional tics in Tourette syndrome) or may emerge independent of a prior neurological history. In this chapter, we review the clinical assessment of children and adolescents with FMD. While the prognosis for FMD in children can be good in many patients, incorporating family and school dynamics into treatment plans increases the likelihood and speed of recovery. Therefore, a detailed psychosocial history is one of the main topics of focus in our clinical assessments for individuals suspected of FMD, and aids in efforts to build communities of care around children with FMD that may add to the benefits of individual therapy.