Trick or treat? Showing patients with functional (psychogenic) motor symptoms their physical signs

Neurology. 2012 Jul 17;79(3):282-4. doi: 10.1212/WNL.0b013e31825fdf63. Epub 2012 Jul 3.


Functional (psychogenic) motor symptoms are diagnosed on the basis of positive signs of inconsistency or incongruity with known neurologic disease. These signs, such as Hoover sign or tremor entrainment, are often regarded by neurologists as 'tricks of the trade,' to 'catch the patient out, ' and certainly not to be shared with them. In this reflective article, the authors suggest that showing the patient with functional motor symptoms their physical signs, if done in the right way, is actually one of the most useful things a neurologist can do for these patients in persuading them of the accuracy of their diagnosis and the potential reversibility of their symptoms.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Electromyography
  • Gait Disorders, Neurologic / psychology
  • Gait Disorders, Neurologic / therapy
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Movement Disorders / psychology*
  • Movement Disorders / therapy*
  • Muscle Weakness / psychology
  • Muscle Weakness / therapy
  • Neurologic Examination
  • Psychophysiologic Disorders / psychology*
  • Psychophysiologic Disorders / therapy*
  • Tremor / diagnosis