機能性（心因性）運動異常症—機能性不随意運動症を中心に

Functional (Psychogenic) Movement Disorder Focusing on Involuntary Movements: A Review

機能性神経障害は，かつて心因性などと言われ，詐病と異なり無意識で生じる神経症状である。診断的手技と陽性身体徴候に基づいた能動的な診断が重要で，すべての器質的疾患の除外は必須ではない。脳神経内科医による病状説明が最も大切で，それ自体が治療になる。疾患頻度が高く，運動障害を専門としない医師も精通する必要がある。本論では，機能性神経障害の中で，機能性に生じる不随意運動症を中心に，動画を交えて概説する。

　

＊本論文中に掲載されている二次元コード部分をクリックすると，関連する動画を視聴することができます（公開期間：2026年1月31日まで公開）。

Abstract

Functional neurological disorders differ from malingering/factitious disorders and are diagnosed based solely on careful history taking and neurological evaluation. Some clinical characteristics, including distractibility, entrainability, and variability are important to identify the positive physical signs that indicate functional alterations. Thorough investigations are not essential to exclude organic pathologies, whereas electrophysiological and radiological findings are sometimes useful. Neurologists play an important role when they explain the diagnosis to the patient. The explanation itself may be therapeutic, when delivered successfully and may help patients to understand the nature and mechanisms underlying their movement disorder. A multidisciplinary team approach, including coordination between rehabilitation therapists and psychotherapists may produce positive treatment outcomes, particularly in movement disorder centers. In this article, we discuss some functional neurological disorders, including those in patients with functional movement disorders (involuntary movements) together with video presentations.