TULBURĂRILE DE MIȘCARE FUNCȚIONALE: SCHIMBARE DE PARADIGMĂ (REVISTA LITERATURII)
DOI:
https://doi.org/10.52692/1857-0011.2024.3-80.08Cuvinte cheie:
Tulburare de mișcare funcțională, neurocircuitare, self-agency, criterii rule-inRezumat
Tulburările neurologice funcționale (TNF) reprezintă un grup de patologii în care este alterată funcționarea sistemului nervos. Ultimele progrese în cercetare au condus la ameliorarea înțelegerii proceselor patofiziologice implicate și la elaborarea unor noi strategii de diagnostic precoce. În mod particular, au beneficiat tulburările de mișcare funcționale (TMF) prin actualizări ale criteriilor de diagnostic și a strategiilor de management.Scopul studiului: Scopul acestei cercetări a fost evaluarea detaliată a literaturii de specialitate în vederea analizei abordării clinice și diagnostice a TMF. Materiale și metode: Sinteza literaturii, realizată în acord cu PRISMA, de către 2 autori (OG, MC), a 47 articole publicate în intervalul 01/2020-06/2024 în limba engleză în PubMed-Medline și ResearchGate, suplimentate cu 7 articole relevante din citații/bibliografii. Rezultate: TMF sunt explicate patofiziologic prin dualitatea: defecte de neurocircuitare cu implicarea sistemelor de self-agency, saliență, procesarea emoțiilor; și influențe psiho-sociale (factorii predispozanți, precipitanți, perpetuanți). Această schimbare de paradigmă a contribuit la dezvoltarea noilor tactici de diagnostic bazate pe criteriile „rule-in” susținute prin pilierii: incongruența, inconsistența, variabilitatea, distractibilitatea; cât și la îmbunătățirea strategiei de comunicare cu pacientul pentru asigurarea complianței. Suplimentar, un management holistic bazat pe reabilitare fizică și psihoterapie, și tratament medicamentos la necesitate, inițiat cât mai precoce este cheie în asigurarea unui tratament eficace și a unei calități de viață. Concluzii: TMF reprezintă o provocare semnificativă în neurologie, dar progresele recente în înțelegerea mecanismelor patofiziologice și adoptarea criteriilor de diagnostic „rule-in” au dus la tratamente mai eficiente și rezultate clinice mai bune. Este crucial ca neurologii să adopte aceste noi abordări pentru a îmbunătăți îngrijirea pacienților și a transforma practica medicală.
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