Table 1
Summary of the Demographic and Clinical Characteristics of Elderly Functional Movement Disorder Patients
| Demographic and clinical characters | Findings | |
|---|---|---|
| 1. | Age range (mean ± SD) | 62–70 (64.77 ± 2.53) years |
| 2 | Male:female | 10:8 |
| 3. | Duration | 1 day to 5 years (mean ± SD; 349.3 ± 427.9 days) |
| 4. | Onset | |
| Abrupt | 7 (38.8%) | |
| Gradual | 11 (61.1%) | |
| 5. | Level of certainity | |
| Documented | 8 (44.4%) | |
| Clinically established | 10 (55.5%) | |
| 6. | Phenomenology | |
| Tremor | 11 (61.1%) | |
| Distribution of tremor* | UL (7), LL (3), head (3) | |
| Dystonia** | 7 (38.8%) | |
| Tics | 2 (11.1%) | |
| Choreoballistic movement | 2 (11.1%) | |
| Hemifacial spasm | 1 (5.5%) | |
| Functional gait | 1 (5.5%) | |
| Multiple types of movements | 7 (38.8%) | |
| 7. | Precipitating factors | 15 (83.3%) |
| Physical trauma including stroke | 4 (22.2%) | |
| Familial disputes | 4 (22.2%) | |
| Spouse’s illness or death | 3 (16.6%) | |
| Death of son | 1 (5.5%) | |
| Financial burden for marriage of her daughters | 1 (5.5%) | |
| Financial debt (loan) | 1 (5.5%) | |
| Claustrophobia during MRI | 1 (5.5%) | |
| None | 3 (16.6%) | |
| 8. | Psychiatric comorbidity | 6 (33.3%) |
| 9. | Outcome | |
| Improved | 8 (44.4%) | |
| Partly improved | 5 (27.7 %) | |
| Not improved | 5 (27.7 %) |
Table 2
Detailed Clinical Features of Elderly Functional Movement Disorder Patients
| Serial number | Age/sex | Duration of disease | Documented (D)/clinically established (CE) | Phenomenology | S | D | V | E | Onset | Precipitating cause | Psychiatric comorbidity | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 62/M | 9 months | D | Rt UL and LL rest tremor | + | + | + | Gradual | Lung lobectomy 1 year back | None | Not improved | |
| 2 | 70/M | 1 year | D | Rt LL rest tremor | + | + | + | + | Abrupt | Recurrent stroke, illness of his wife | None | Partly improved |
| 3 | 66/M | 6 months | D | Tics and retrocollis | + | + | Abrupt | Death of his son | None | Improved | ||
| 4 | 62/M | 7 days | D | Rt torticollis and head tremor | + | + | + | Gradual | Financialdebt | Panic attacks | Improved | |
| 5 | 62/M | 18 months | D | Tics (shoulder shrugging), platysmal contractin, oromandibular including tongue dystonia | + | + | + | Gradual | Road traffic accident 4 years back | Anxiety | Partly improved | |
| 6 | 63/M | 2 years | D | UL dystonia with writer’s cramp | + | + | + | Gradual | Familial dispute | Depression | Not improved | |
| 7 | 68/M | 5 years | D | Choreobalistic movement | + | + | + | Gradual | None | Anxiety | Not improved | |
| 8 | 65/F | 1 day | D | Lip smacking | + | + | + | Abrupt | Calustrophobia during MRI | None | Improved | |
| 9 | 63/F | 9 months | CE | Left hemifacial spasm | + | + | Abrupt | Dispute with son | None | Improved | ||
| 10 | 65/F | 4 months | CE | Rt hand tremor and dystonia | + | + | Gradual | Familial conflict | Depression | Improved | ||
| 11 | 68/M | 6 months | CE | Head tremor | + | Gradual | Familial dispute | None | Partly improved | |||
| 12 | 64/M | 8 months | CE | Both LL tremor | + | Abrupt | Wife’s death | None | Improved | |||
| 13 | 63/F | 6 months | CE | Lt hand rest and postural tremors | + | + | + | Gradual | Financial burden for marriage of her daughters | Anxiety | Not improved | |
| 14 | 65/F | 1 year | CE | Rt UL choreoballlistic movement and functional gait | + | + | Abrupt | None | None | Improved | ||
| 15 | 65/F | 6 months | CE | Postural hand tremor | + | + | + | Gradual | Husband’s death 7 months back | None | Improved | |
| 16 | 69/F | 15 days | CE | Head and both hand tremor | + | Abrupt | Accidental fall 5 months back | None | Partly improved | |||
| 17 | 62/M | 3 months | CE | Rest and postural tremor and dystonia of Lt UL | + | Gradual | Wife’s illness | None | Partly improved | |||
| 18 | 64/F | 2 years | CE | Rest and postural tremor, Lt hand dystonia | + | + | + | Gradual | None | None | Not improved |
[i] M, male; F, female; S, suggestibility; V, variability; D, distractibility; E, entrainment; O, onset; Lt, left; Rt, right; UL, upper limb; LL, lower limb; MRI, magnetic resonance imaging.
Video 1
Functional movement disorder in elderly (case 1–8). Abnormal movements, variability and distractibility are seen in different patients.