Functional movement disorders (FMDs), also known as psychogenic movement disorders (PMDs), should be considered a biological-psychological-social disease like other functional neurological diseases. It is not merely a psychological or mental disease. The etiology of FMDs includes neurobiological changes, such as abnormal patterns of cerebral activation and abnormal connectivity between the limbic system and the motor networks. Inheritance and epigenetic machinery, such as DNA methylation and changes in grey and white matter morphology, may influence the development of FMDs. FMDs are not rare in the outpatient service of pediatrics and are one of the most challenging movement disorders due to complex and diversified clinical manifestations. Due to a lack of clinical knowledge and unified diagnostic criteria, it is difficult for pediatricians to make a correct diagnosis of FMDs, which may be easily confused with other diseases. Pediatricians should pay more attention to children with FMDs and establish a multidisciplinary team with psychiatrists, specialists in developmental behavior, and physiotherapists, so as to provide active management and treatment for such children.
功能性运动障碍(FMDs)也称心因性运动障碍(PMDs),与其他功能性神经疾病类似,FMDs应被视为一种生物-心理-社会性疾病,而并非仅仅是心理或精神疾病。FMDs病因包括神经生物学变化,如大脑激活模式异常以及边缘系统和运动网络之间的连接异常。遗传和表观遗传学机制,如DNA甲基化、灰质和白质形态发育的改变可能影响FMDs的发生。FMDs在儿科门诊并不少见,其临床表现形式复杂多样,是最具挑战性的运动障碍之一。由于临床认识不足,目前缺乏统一的诊断标准,使儿科医生诊断FMDs存在困难,容易与其他疾病混淆。儿科医生应该更多关注FMDs患儿,并与精神科医生、发育行为学专家和物理治疗师组成多学科团队,使FMDs患儿得到更积极地管理和治疗。