功能性运动障碍的诊断与治疗中国专家共识第二版

标题: 功能性运动障碍的诊断与治疗中国专家共识第二版
title: Chinese expert consensus on the diagnosis and treatment of functional movement disorders (the 2nd version)
版本: 更新版
version: Updated
分类: 专家共识
classification: Experts consensus
领域: 诊疗
field: Diagnosis and Treatment
国家和地区: 中国
Country and region: China
指南使用者: 内科医师,包括神经内科医师、运动障碍疾病专科医生和精神科、心理科医生,以及康复师
Guide users: clinicians, including neurologist, movement disorders specialists and Psychiatrist, and rehabilitation physician
证据分级方法: JBI 证据推荐级别系统(2014版本)
Evidence grading method: JBI Levels of Evidence (2014)
制定单位: 上海交通大学医学院附属瑞金医院
Formulating unit: Ruijin Hospital Affiliated To Shanghai Jiao Tong University School of Medicine
注册时间: 2023-05-23
Registration time:
注册编号: PREPARE-2023CN351
Registration number:
指南制订的目的: 功能性运动障碍(Functional movement disorders, FMDs),又称心因性运动障碍(Psychogenic movement disorders, PMDs)是非常有代表性的功能性神经系统疾病,FMDs的病因及发病机制目前尚不明确。FMDs临床特征为患者出现的各类功能性运动障碍症状,或患者症状与已知器质性疾病不相符。多数FMDs患者都曾有巨大压力、焦虑或抑郁等精神疾病史,部分患者甚至长期受应激压力影响。目前,FMDs在运动障碍门诊的占比为3-6%,我国至今尚无确切的流行病学资料。起病年龄35-50岁,女性更常见,但实际发病人群更广。FMDs现已成为运动障碍疾病的重要分支,但多数临床医师(尤其是内科、神经内科和精神科医师)对此疾病的认知不足,在面对此类患者时常常束手无策。在国内多位知名神经内科、精神科和神经电生理专家紧密合作的基础上,结合自身临床实践经验及国内外最新进展,系统总结了FMD诊断和治疗进展,2021年首次在国内推出了功能性运动障碍的诊断与治疗中国专家共识。本次拟系统总结近2年关于FMD诊断和治疗的研究进展,在初版基础上进行更新和修订,推出第二版功能性运动障碍的诊断与治疗中国专家共识。
Purpose of the guideline: Functional movement disorders (FMDs), also known as psychogenic movement disorders (PMDs), are very representative functional neurological diseases, and the etiology and pathogenesis of FMDs are not yet clear. FMDs are characterized by various movement dysphylaxis symptoms, or symptoms inconsistent with known organic diseases. Most patients with FMDs have a history of mental illness such as stress, anxiety or depression, and some patients are even affected by stress for a long time. At present, FMDs account for 3-6% of movement disorder clinics, and there is no accurate epidemiological data in China. The age of FMDs onset is 35 to 50 years, and it is more common in women, but the actual incidence is wider. FMDs have now become an important subtype of movement disorders, but most clinicians (especially medical, neurologists, and psychiatrists) are poorly aware of the disease and are often helpless when dealing with such patients. The original version of Chinese expert consensus on the diagnosis and treatment of functional movement disorders was firstly developed in 2021 in China based on research and clinical experience from experts. Now, we are aiming the second version consensus with revisement and update based on original version.