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Psychogenic movement disorders are relatively common in movement disorders clinics. Establishing a psychogenic movement disorder is important to direct appropriate therapies but also to avoid unnecessary and potentially dangerous investigations and treatments, including surgical interventions. While the diagnosis is primarily based on clinical criteria, electrophysiologic testing is often helpful in establishing the diagnosis of certain types of psychogenic movement disorders. For example, entrainment, distraction, as well as coherence between voluntary and psychogenic movements are often present in psychogenic but not in organic tremor.1,2 Psychogenic muscle jerks can be distinguished from organic myoclonus based on the duration and pattern of EMG activities.3
Dystonia is characterized by cocontraction of agonist and antagonist muscles, and overflow of muscle contraction, which refers to activation of muscles not required to perform the desired action. This may be due to impaired inhibition at multiple levels in the CNS. In dystonia, there is reduced reciprocal inhibition in the spinal cord; …
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