• Béatrice Garcin, Emmanuel Roze, Francine Mesrati, Emmanuel Cognat, Emmanuel Fournier, Marie Vidailhet, and Bertrand Degos.
• Département de Neurologie, Hôpital Pitié-Salpêtrière, Centre de Référence Maladie de Parkinson, APHP, Paris, France.
• J. Neurol. Neurosurg. Psychiatr.. 2013 Sep 1;84(9):1043-6.

BackgroundManagement of psychogenic movement disorders (PMDs) is challenging for neurologists and, to date, there is no consensus about their treatment. Recent studies suggested a possible therapeutic effect of repeated transcranial magnetic stimulation (TMS) in psychogenic paralysis and tremor.ObjectiveTo document the clinical impact of TMS in PMDs.MethodsWe blindly video scored symptoms of consecutive patients with PMD who were recorded before and after TMS. TMS was delivered at low frequency (0.25 Hz) over the motor cortex contralateral to symptoms.ResultsTwenty-four patients were included. They presented with dystonia, myoclonus, tremor, Parkinsonism or stereotypies. The median duration of symptoms before TMS was 2.8 years (6 months to 30 years). The overall score of 75% of patients improved by >50% and, furthermore, the clinical benefits were sustained upon protracted follow-up (median 19.8 months). There was no correlation between improvement and duration of symptoms before TMS.ConclusionsTMS is a therapeutic option for PMDs, including chronic PMDs.

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