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Fortschr Neurol Psychiatr 2008; 76(11): 647-654
DOI: 10.1055/s-2008-1038266
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Psychogener Tremor

Klinik, Zusatzdiagnostik, Differenzialdiagnose und therapeutische AnsätzePsychogenic TremorClinical Features, Diagnostic Approaches, Differential Diagnosis and Therapeutic ConsiderationsM.  Dafotakis1, 2 , C.  Schönfeldt-Lecuona3 , G.  R.  Fink1, 2 , D.  A.  Nowak1, 2
  • 1Klinik und Poliklinik für Neurologie, Klinikum der Universität zu Köln (Direktor: Univ.-Prof. Dr. G. R. Fink)
  • 2Institut für Neurowissenschaften und Biophysik – Medizin, Kognitive Neurologie (Direktor: Univ.-Prof. Dr. G. R. Fink), Forschungszentrum Jülich
  • 3Klinik für Psychiatrie und Psychotherapie III (Direktor: Univ.-Prof. Dr. Dr. M. Spitzer), Universität Ulm
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Publication History

Publication Date:
05 November 2008 (online)

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Zusammenfassung

Mit ca. 40 % aller psychogenen Bewegungsstörungen ist der psychogene Tremor die häufigste psychogene Bewegungsstörung. Der psychogene Tremor stellt eine klinische Herausforderung dar, der durch entsprechende klinische Fertigkeiten und den Einsatz adäquater Zusatzuntersuchungen begegnet werden kann, um eine positive Diagnose zu stellen. Ein akuter Beginn sowie eine variable Ausprägung der Symptomatik sind häufig zu beobachten. Darüber hinaus tragen spezielle klinische Provokationsmanöver zur Diagnosestellung bei. Die vorliegende Übersichtsarbeit widmet sich der klinischen Präsentation, der Differenzialdiagnose und der Zusatzdiagnostik des psychogenen Tremors, diskutiert therapeutische Optionen und stellt neue therapeutische Methoden wie den Einsatz der transkraniellen Magnetstimulation vor.

Abstract

Psychogenic tremor is the most common psychogenic movement disorder and accounts for up to 40 % of all psychogenic movement disorders. Patients suffering from psychogenic tremor may show positive clinical criteria like acute onset, distractibility, inconsistent frequency and amplitude of tremor or an intermittent occurrence. Moreover, there exist a few supportive clinical tests and diagnostic tools, which help to suggest a psychogenic origin of the disease, e. g., electromyographic or kinematic recordings. In this review the clinical presentation of psychogenic tremor and diagnostic approaches are discussed. In addition, novel therapeutic approaches, e. g., application of transcranial magnetic stimulation techniques are introduced.

Schlüsselwörter

funktionelle Störungen - kinematische Bewegungsanalyse - Somatisierungsstörung - Simulation - Psychotherapie

Key words

kinematic motion analysis - transcranial magnetic stimulation - psychotherapy - somatisation - functional disorder - malingering

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Dr. Manuel Dafotakis

Institut für Neurowissenschaften und Biophysik – Medizin, Forschungszentrum Jülich

Leo-Brandt-Str. 1

52428 Jülich

Email: m.dafotakis@fz-juelich.de