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Delorme C, Giron C, Bendetowicz D, Méneret A, Mariani LL, Roze E. Current challenges in the pathophysiology, diagnosis, and treatment of paroxysmal movement disorders. Expert Rev Neurother 2020; 21:81-97. [PMID: 33089715 DOI: 10.1080/14737175.2021.1840978] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Paroxysmal movement disorders mostly comprise paroxysmal dyskinesia and episodic ataxia, and can be the consequence of a genetic disorder or symptomatic of an acquired disease. AREAS COVERED In this review, the authors focused on certain hot-topic issues in the field: the respective contribution of the cerebellum and striatum to the generation of paroxysmal dyskinesia, the importance of striatal cAMP turnover in the pathogenesis of paroxysmal dyskinesia, the treatable causes of paroxysmal movement disorders not to be missed, with a special emphasis on the treatment strategy to bypass the glucose transport defect in paroxysmal movement disorders due to GLUT1 deficiency, and functional paroxysmal movement disorders. EXPERT OPINION Treatment of genetic causes of paroxysmal movement disorders is evolving towards precision medicine with targeted gene-specific therapy. Alteration of the cerebellar output and modulation of the striatal cAMP turnover offer new perspectives for experimental therapeutics, at least for paroxysmal movement disorders due to selected causes. Further characterization of cell-specific molecular pathways or network dysfunctions that are critically involved in the pathogenesis of paroxysmal movement disorders will likely result in the identification of new biomarkers and testing of innovative-targeted therapeutics.
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Affiliation(s)
- Cécile Delorme
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France
| | - Camille Giron
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France
| | - David Bendetowicz
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France.,Inserm U 1127, CNRS UMR 7225- Institut du cerveau (ICM), Sorbonne Université , Paris, France
| | - Aurélie Méneret
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France.,Inserm U 1127, CNRS UMR 7225- Institut du cerveau (ICM), Sorbonne Université , Paris, France
| | - Louise-Laure Mariani
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France.,Inserm U 1127, CNRS UMR 7225- Institut du cerveau (ICM), Sorbonne Université , Paris, France
| | - Emmanuel Roze
- Département de Neurologie, AP-HP, Hôpital Pitié-Salpêtrière , Paris, France.,Inserm U 1127, CNRS UMR 7225- Institut du cerveau (ICM), Sorbonne Université , Paris, France
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Ganos C, Edwards MJ, Müller-Vahl K. "I swear it is Tourette's!": On functional coprolalia and other tic-like vocalizations. Psychiatry Res 2016; 246:821-826. [PMID: 27825787 DOI: 10.1016/j.psychres.2016.10.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 10/11/2016] [Accepted: 10/16/2016] [Indexed: 11/17/2022]
Abstract
Coprolalia in neuropsychiatry is typically associated with tic disorders, in particular Gilles de la Tourette syndrome. To date, there has been no report of functional coprolalia. Here, we provide the clinical characteristics of 13 adolescent and adult patients with coprolalic and other functional tic-like complex vocalizations who, on the basis of these symptoms, were misdiagnosed with a primary tic disorder, most commonly Gilles de la Tourette syndrome. We describe similarities and highlight the differences from primary tic disorders in order to provide a pragmatic list of clinical clues that will facilitate correct diagnostic labeling and thereby treatment. Finally, we emphasize that the distinction between a primary and a functional tic disorder should rely on a combination of neuropsychiatric symptoms and signs and not on the presence of single, however striking, abnormal behaviors, such as coprolalia.
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Affiliation(s)
- Christos Ganos
- Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany; Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute, UK
| | - Mark J Edwards
- Department of Cell Sciences, St George's University of London, Cranmer Terrace, London, UK
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, d-30625, Hannover, Germany.
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Erro R, Brigo F, Trinka E, Turri G, Edwards MJ, Tinazzi M. Psychogenic nonepileptic seizures and movement disorders: A comparative review. Neurol Clin Pract 2016; 6:138-149. [PMID: 27104066 DOI: 10.1212/cpj.0000000000000235] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE OF REVIEW Neurologic symptoms due to a psychogenic cause are frequently seen in clinical practice. Psychogenic nonepileptic seizures (PNES) and psychogenic movement disorders (PMD) are among the most common psychogenic neurologic disorders. PNES and PMD are usually investigated and managed separately by different neurology subspecialists. We review the main epidemiologic and clinical features of both PNES and PMD, aiming to highlight their similarities and differences and to see whether a common framework for these disorders exists. RECENT FINDINGS Data from the literature show that there is a profound overlap between PNES and PMD, which would argue for a larger unifying pathophysiology with variable phenotypic manifestations. SUMMARY Collaborative and integrated research among epileptologists, movement disorders experts, psychiatrists, psychologists, and physiotherapists may increase our collective knowledge about the pathophysiologic mechanisms of PNES and PMD and therefore improve outcomes for these patients.
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Affiliation(s)
- Roberto Erro
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
| | - Francesco Brigo
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
| | - Eugen Trinka
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
| | - Giulia Turri
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
| | - Mark J Edwards
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
| | - Michele Tinazzi
- Sobell Department of Motor Neuroscience and Movement Disorders (RE, MJE), University College London (UCL) Institute of Neurology, UK; Dipartimento di Neuroscienze, Biomedicina e Movimento (RE, FB, GT, MT), Università di Verona; Divisione di Neurologia (FB), Ospedale "Franz Tappeiner," Merano, Italy; Department of Neurology (ET), Christian Doppler Klinik, Paracelsus Medical University; and Centre for Cognitive Neuroscience (ET), Salzburg, Austria
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