Manejo del trastorno del movimiento funcional
DOI:
https://doi.org/10.22379/anc.2143Palabras clave:
Trastorno del movimiento funcional, Trastorno neurológico funcional, Trastorno de conversión, Neurología, DiscapacidadResumen
Introducción: el trastorno del movimiento funcional (TMF), dentro del espectro del trastorno neurológico funcional (TNF), es una causa frecuente de discapacidad y de uso repetido de servicios de urgencias y hospitalización. Aunque el diagnóstico se basa en signos clínicos positivos y no en la exclusión, persisten lagunas sobre qué hacer después: cómo comunicarlo, estructurar el plan terapéutico y articular el trabajo transdisciplinario.
Objetivo: ofrecer una síntesis práctica y actualizada del manejo del TMF una vez confirmado el diagnóstico.
Materiales y métodos: se realizó una revisión narrativa de la literatura reciente sobre TMF y TNF, incluyendo guías clínicas, revisiones sistemáticas, estudios observacionales y consensos de expertos, complementada con la experiencia clínica de los autores en clínicas especializadas. La información se organizó según ejes temáticos y contextos asistenciales.
Resultados: la literatura respalda el uso de signos clínicos positivos para establecer el diagnóstico y destaca que una comunicación clara y empática constituye un componente terapéutico fundamental. La evaluación de comorbilidades, el uso prudente de estudios complementarios, la fisioterapia centrada en el reentrenamiento motor y las estrategias cognitivo-conductuales forman parte esencial del manejo.
Conclusión: elementos como un abordaje integrado, centrado en el diagnóstico afirmativo; la explicación estructurada; la rehabilitación específica; y el tratamiento de comorbilidades pueden mejorar la funcionalidad y reducir la cronicidad.
Biografía del autor/a
Sergio Castillo Torres, Servicio de Neurología, Departamento de Medicina Interna, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, México
Escuela de Medicina y Ciencias de la Salud, Tecnológico de Monterrey, Monterrey, México
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