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functional movement disorders

Functional Movement Disorders in the Younger Senior Adult Population

Functional movement disorders (FMD) are a subset of a group of disorders called functional neurological disorders (FND). 

A 2022 study shows that, unlike many other neurological diseases, they can affect a much younger population group and that women are more likely to have FMD than men.

Functional movement disorders occur when someone experiences unusual, involuntary body positions or movements. They are caused by problems with how signals are sent through the brain. 

Other terms for functional movement disorders include conversion disorders and psychogenic movement disorders. 

Unlike movement disorders like Parkinson’s disease or other damage-induced diseases, FMD is not caused by disease or damage to the nervous system. Because of this, treatments are available, and cures are possible. 

As part of Our Promise to love and care for our residents as we would our own loved ones, The Kensington White Plains has put together this introductory guide to functional movement disorders to help you understand this condition. 

What are FNDs, and what are functional neurological symptoms? 

Functional neurological disorders (FND) are a group of disorders that typically have distressing, disabling neurological symptoms and signs that can’t be accounted for by other known disease entities. 

Examples of physical symptoms include tremors or shaking that are not typical of essential tremors or Parkinson’s disease. 

However, unlike many neurological diseases, FND has no structural or degeneration damage to the nervous system. 

Instead, FND involves a malfunction or functional problem in the brain that might be reversible. FNDs manifest with both physical symptoms and sensory symptoms typically seen in neurology clinics such as: 

  • Seizure-like episodes 
  • Abnormal sensations
  • Weakness
  • Pain
  • Movement disorders
  • Walking problems

Functional movement disorders (FMD) make up a significant portion of FNDs but may have slightly differing symptoms. 

FMD sufferers, specifically, may have symptoms such as:

  • Shaking or tremors
  • Abnormal muscle spasms
  • Abnormal posting (sometimes called dystonia)
  • Jerky movements (sometimes referred to as myoclonus)

The symptoms of FMD can manifest with various abnormal movements, possibly even mimicking Parkinson’s disease or multiple types of movement disorders simultaneously. 

Symptoms generally come on suddenly and can quickly become severe—but can also fluctuate in type, frequency, location, and severity. They can also occur in combination with different movement disorders as well as independently. 

Primary psychiatric disorders like depression and anxiety may already be present but may not have been previously diagnosed. In other words, the person may have anxiety or depression issues that were not officially diagnosed before the symptoms of functional movement disorder.

What triggers functional movement disorder?

As with many neurological disorders and diseases, the precise cause of FMD remains unclear—particularly because FMD is caused by a functional change in the brain and is not a result of structural damage. 

Disorders of this type are often triggered by physical or emotional events or illnesses. These disorders used to be referred to as “psychogenic disorders” because psychological stressors or symptoms triggered symptoms. 

These triggers may not always be evident to the patient or the physician—and such an event is not always necessary to trigger FMD either. Nonetheless, FMD is thought to result from a complex interaction between neurology and psychology.  

What is the difference between essential tremor and a functional tremor?

Essential tremor (ET) occurs when certain areas of the brain start to malfunction, sending faulty signals to the thalamus that sends movement signals to the head and limbs. 

These faulty brain areas mean a physical cause of Essential Tremor, and those suffering its effects might respond to surgical or pharmaceutical treatments. 

A functional tremor (FT) occurs when the nervous system itself is not working correctly and may be triggered by certain psychological or emotional states. Even though no physical cause can be discovered, it’s important to recognize that the tremors are quite real and not imaginary. 

Age of onset for functional movement disorders and symptoms

Looking at almost five thousand individual cases of functional movement disorders, researchers found that

  • 72.6% were women
  • 39.6 years was the mean age at onset 
  • Women had an earlier age of onset (39.1 vs. 41.0 years)

They also found that 23.1% of cases had mixed FMD, 21.6% had tremors, and 18.1% experienced weakness. Overall, these three were the most common symptoms found.

Of these three symptoms, tremors are more likely to show up last (at a mean age of 40.7 years), whereas dystonia or muscle spasms (34.5 years) and weakness (36.4 years) might appear at younger ages. 

A less common symptom, gait disorders, had a significantly later age of onset at 43.2 years.

Other studies have found that FMD largely affects those aged 50 or younger, but rare cases can appear in the elderly around age 60. It’s also suspected that previous experience with depression, anxiety, and other psychiatric illnesses is common in those 60 and over who have been diagnosed with FMD. 

What treatments for FMD are available? 

Even though FMD occurs fairly frequently, there aren’t any standardized treatments. Successful treatment plans have to be individualized and based on the clinical features of each patient. 

In general, the quicker a diagnosis is made, and treatments are started, the greater the likelihood that symptoms can be reversed. 

Successful approaches include:

  • Physical therapy
  • Medications, like antidepressants
  • Psychotherapy
  • A combination of the above

However, the essential part of any treatment plan is open communication and an understanding of FMD by caregivers, healthcare providers, and the patients. Long-term follow-ups by a physician are also generally recommended. 

In many cases, the proper care from the right medical professionals and facilities can improve symptoms or possibly even resolve them. 

Providing strength for those with movement disorders at The Kensington White Plains

Rehabilitation doesn’t just mean physical therapy; it doesn’t have to be just for those experiencing difficulties such as functional neurological symptoms. 

While working toward enriching the lives of our loved ones, we often find that there are many paths that can lead us to a better tomorrow.

Beyond improving the physical well-being of people, rehabilitation and other types of therapy like music, proper nutrition, and cognitive care might help bring out the best years of our residents’ lives. 

Reach out to The Kensington White Plains today, and one of our dedicated team members can go over the special services available. 

Whether you are dealing with debilitating diseases like ALS or MS or are looking to get a helping hand through assisted living or enhanced assisted living for your loved ones, The Kensington White Plains could be the right solution for your situation.

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