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Brief Report

Functional movement disorders are not uncommon in the elderly

  1. Amit Batla MD DM (Neuro)1,
  2. Maria Stamelou MD, PhD1,
  3. Mark J. Edwards MD1,
  4. Isabel Pareés MD1,
  5. Tabish A. Saifee MRCP1,
  6. Zoe Fox PhD2,
  7. Kailash P. Bhatia MD FRCP1,*

Article first published online: 15 FEB 2013

DOI: 10.1002/mds.25350

Issue

Movement Disorders

Movement Disorders

Volume 28, Issue 4, pages 540–543, April 2013

Additional Information

How to Cite

Batla, A., Stamelou, M., Edwards, M. J., Pareés, I., Saifee, T. A., Fox, Z. and Bhatia, K. P. (2013), Functional movement disorders are not uncommon in the elderly. Mov. Disord., 28: 540–543. doi: 10.1002/mds.25350

Author Information

  1. 1

    Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, London, United Kingdom

  2. 2

    Department of Biostatistics, UCL Institute of Neurology, University College London, London, United Kingdom

*Correspondence to: Prof. K. P. Bhatia, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, United Kingdom; k.bhatia@ion.ucl.ac.uk

  1. Relevant conflicts of interest/financial disclosures: Nothing to report.

  2. Full financial disclosures and author roles may be found in the online version of this article.

Publication History

  1. Issue published online: 8 APR 2013
  2. Article first published online: 15 FEB 2013
  3. Manuscript Accepted: 16 DEC 2012
  4. Manuscript Revised: 30 NOV 2012
  5. Manuscript Received: 31 OCT 2012

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Keywords:

  • functional movement disorders;
  • elderly;
  • psychogenic;
  • gait;
  • psychogenic non epileptic seizures

ABSTRACT

Background

Functional movement disorders (FMDs) are thought to be rare in the elderly. Clinical characteristics of the elderly people who develop FMDs are rarely reported. The objective of this study was to highlight the clinical characteristics of FMD in the elderly and compared these with a cohort of patients with a younger age of onset.

Methods

The authors performed a retrospective review of the clinical records of patients with FMD who were seen at their center in the last 5 years and had consented to be included in research studies. Patients fulfilling currently accepted diagnostic criteria for FMD as documented, clinically established, or probable were included.

Results

Of 151 patients with FMD who were identified and had sufficient information, 21.0% (n=33) had an onset after age 60 years (elderly group). The mean age of onset of FMD was 63.5 years (standard deviation, 5.2 years) in the elderly group and 35.5 years (standard deviation, 12.6 years) in the younger group. Tremor was the most common movement disorder in both groups (elderly group, 33.3%; younger group: 38.9%). Fixed dystonia was not observed in any patient who had an FMD onset after age 60 years. Gait abnormalities were significantly more common in the elderly group (69.7%) than in younger patients (23.5%; P<0.001). Associated psychogenic nonepileptic seizures tended to be more common in elderly patients (18.2%) compared with younger patients (13%; P=0.06).

Conclusions

Contrary to common perceptions, FMDs are not uncommon in the elderly, and 1 in 5 patients in the current cohort, onset of FMD occurred after age 60 years. Gait abnormalities and psychogenic nonepileptic seizures may be more common in older patients. © 2013 Movement Disorder Society

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