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Case series reveals functional motor disorders developing after resolution of cerebrovascular lesions, indicating the need for positive diagnostic criteria.
BACKGROUND: Functional motor disorders encompass a variety of manifestations characterized by abnormal movements that are clinically incongruent with those known to be caused by neurological diseases. CASES: We report 2 cases in which functional motor disorders developed after complete recovery of motor symptoms originating from underlying vascular brain lesions. The first case describes a young woman who developed a motor and sensory hemisyndrome after surgical removal of a postrolandic cavernoma. The second describes a 16-year-old girl who presented with a mixed component tremor after ventricular derivation and endovascular embolization for rupture of a brainstem arteriovenous malformation. CONCLUSION: Motor symptoms and signs attributed to an underlying lesion may trigger "pure" functional motor disorders. In such cases, the differential diagnosis may be even more challenging. However, diagnosis of a functional rather than a defined structural disorder can be achieved by a "positive diagnostic process," considering the findings of internal inconsistency and incongruity.
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Paio et al. (2020) studied this question.
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