Gender Differences in Functional Movement Disorders

Background Functional neurological disorders are generally more common in females than males, but the reason for this gender difference is not well understood. Objectives In this study, we aim to compare the clinical and demographic features of functional movement disorders (FMDs) between males and females. Methods We examined clinical data and video-recordings of patients with FMDs evaluated at the Baylor College of Medicine Movement Disorders Clinic. Results Of the 196 patients with FMDs, males represented only 30% (n = 59) of the entire cohort. Men had an older age at onset: 40.5 versus 34.1 years (P = 0.026) and an older age at evaluation: 43.8 versus 38.1 years (P = 0.041) compared to women. Functional dystonia was more frequently observed in women: 47.5 versus 20.3% (P < 0.001), but there was a trend for higher frequency of functional gait disorder in men: 44 versus 30% (P = 0.056). Females were particularly over-represented (73.7%) in children and adolescents; but the genders were equally represented in patients aged >= 50 years. Conclusions Female patients are over-represented in FMDs, except in individuals aged >= 50 years. Compared to female patients, males with FMDs present later in life and are less likely to have functional dystonia.