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Simulated gait abnormalities involve weakness of 1 or both legs or ataxia and trembling.The patterns rarely duplicate those of neurologic disability and are usually promptly suspected of being functional by the experienced clinician.As with other pseudoneurologic signs,normal underlying neurologic function must be demonstrated.A dramatic cure is the best diagnostic evidence,and a bias toward organic etiology is warranted by a relatively greater risk in delayed diagnosis.Dystonia and chorea are the signs most likely to be mistaken for functional conditions.While CT and MRI now provide a welcome diagnostic safety net,the variety of hysterical gaits,and probably the effectiveness of"moral"treatment,does not appear to have changed appreciably in the past century. |
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