Assessing Functional Motor Weakness: A Practical Guide

This comprehensive review focuses on validated techniques used by clinicians to assess functional motor weakness, also known as functional neurological symptom disorder, which is a common presentation in neurology. The article discusses the importance of employing specific, studied examination methods to distinguish functional weakness from objective neurological weakness, which arises from structural or electrophysiological causes. Several diagnostic signs are described, including Hoover's sign, give-way weakness, the abductor sign, the abduction finger sign, the spinal injuries center test, motor inconsistency, drift without pronation, paradoxical wrist flexion, and the elbow flex-ex sign, detailing their techniques, interpretation, and limitations based on existing research. The review emphasizes that interpreting these findings should occur within a full neurological examination, potentially using multiple techniques to improve diagnostic accuracy and patient care.