Psychogenic Movement Disorders: Neurology and Neuropsychiatry

Book Review Psychogenic Movement Disorders: Neurology and Neuropsychiatry, edited by Mark Hallett, Stanley Fahn, Joseph Jankovic, Anthony E. Lang, C. Robert Cloninger, and Stuart C. Yudofsky, 353 pp, with illus, $99, Philadelphia, Pa, Lippincott Williams & Wilkins (telephone: 800-638-3030), 2006, ISBN 0-7817-9627-X Type and Scope of Book: A 37-chapter text on psychogenic movement disorders, which is the product of an October 2003 symposium; the participants each authored a chapter. Contents: Almost no area is less understood in neurology than the topic of this text, psychogenic movement disorders. These are dysfunctional motor conditions without a structural or biochemical disease-substrate. Phenotypes include tremor, unusual gaits, paralysis, posturing (dystonia), or other hyperkinetic movements. Many fundamental issues are debated and discussed in this text. Do these disabling disorders arise in the unconscious mind? What is the unconscious mind? Are these patients truly unaware of the origins? Is there usually a basis in psychopathology? Many readers will find the philosophical discussions fascinating, and chapters are flavored with historical perspectives dating to Freud. On a practical level, the challenge to clinicians is distinguishing these from true organic diseases/conditions. Certain chapters provide guidelines and clinical pearls, but basic clinical neurologic expertise is necessary to appropriately use this wisdom. The ultimate challenge is treatment, and in many patients symptoms fail to remit over years of follow-up. Multiple chapters address the therapeutic state of the art, which is a work in progress. Strengths: This is the first comprehensive text on this subject in the modern era of neuropsychiatry. It provides a reference point for future research and development. Deficiencies: The primary deficiency is the failure to outline a reliable and confirmed treatment strategy for these disorders. However, that is a criticism of the field, rather than of the authors of this text. Recommended Readership: Neurologists and psychiatrists. Overall Grading: #### J. Eric Ahlskog, PhD, MD, Section of Movement Disorders, Mayo Clinic College of Medicine, Rochester, Minn

Grading Key ★★★★★ = outstanding; ★★★★ = excellent; ★★★ = good; ★★ = fair; ★ = poor.

© 2006 Mayo Foundation for Medical Education and Research

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