Abstract：
BACKGROUND: Since the COVID-19 pandemic, movement disorder clinics have seen an increase in patients with an unusual type of tic-like symptoms: young adults with abrupt onset complex behaviors. It was quickly suspected that these patients suffered from functional neurological symptoms, later named Functional Tic-Like Behaviors (FTLB). Subsequent research on the differential diagnosis between FTLB and tics has been substantial and led to the development of diagnostic checklists.
OBJECTIVE: We conducted a theoretical reappraisal of the FTLB literature to clarify the validity of the concept and its diagnostic implications.
METHODS: This paper addresses several key aspects of the current FTLB literature: circular reasoning, the complications of the FTLB phenomenology and demographics, the impact of FTLB on tic literature at large, and issues with alignment of the FTLB concept with the diagnostic criteria for functional disorders.
RESULTS: The clinical approach to FTLB might involve circular reasoning due to a lack of clinical benchmarks. The FTLB phenomenology and demographics may need more work to ensure a lack of bias and a proper description of this patient group including a clear distinction from tics. The impact of the FTLB discussion on the wider literature needs consideration. The validation of positive signs may help with both these endeavors and pave way to the inclusion of FTLB within psychiatric classification systems. Furthermore, the coexistence of FTLB and tics within the same patient needs to be addressed.
CONCLUSIONS: More research may be needed to fully establish the diagnosis of FTLB and differentiate it from tics.
OBJECTIVE: We conducted a theoretical reappraisal of the FTLB literature to clarify the validity of the concept and its diagnostic implications.
METHODS: This paper addresses several key aspects of the current FTLB literature: circular reasoning, the complications of the FTLB phenomenology and demographics, the impact of FTLB on tic literature at large, and issues with alignment of the FTLB concept with the diagnostic criteria for functional disorders.
RESULTS: The clinical approach to FTLB might involve circular reasoning due to a lack of clinical benchmarks. The FTLB phenomenology and demographics may need more work to ensure a lack of bias and a proper description of this patient group including a clear distinction from tics. The impact of the FTLB discussion on the wider literature needs consideration. The validation of positive signs may help with both these endeavors and pave way to the inclusion of FTLB within psychiatric classification systems. Furthermore, the coexistence of FTLB and tics within the same patient needs to be addressed.
CONCLUSIONS: More research may be needed to fully establish the diagnosis of FTLB and differentiate it from tics.
摘要：
背景：自COVID-19大流行以来，运动障碍诊所发现，具有不寻常类型抽动样症状的患者有所增加：具有突然发作的复杂行为的年轻人。人们很快怀疑这些患者患有功能性神经症状，后来被称为功能性抽动样行为(FTLB)。随后对FTLB和Tics之间的鉴别诊断进行了大量研究，并导致了诊断清单的开发。
目的：我们对FTLB文献进行了理论重新评估，以阐明该概念的有效性及其诊断意义。
方法：本文讨论了当前FTLB文献的几个关键方面：循环推理，FTLB现象学和人口统计学的并发症，FTLB对TIC文献的影响，以及FTLB概念与功能障碍诊断标准的一致性问题。
结果：由于缺乏临床基准，FTLB的临床方法可能涉及循环推理。FTLB现象学和人口统计可能需要更多的工作，以确保缺乏偏见和对该患者组的适当描述，包括与抽搐的明确区分。FTLB讨论对更广泛文献的影响需要考虑。积极体征的验证可能有助于这两种努力，并为将FTLB纳入精神病学分类系统铺平道路。此外，需要解决同一患者体内FTLB和抽动共存的问题.
结论：可能需要更多的研究来全面确定FTLB的诊断并将其与抽搐区分开来。
目的：我们对FTLB文献进行了理论重新评估，以阐明该概念的有效性及其诊断意义。
方法：本文讨论了当前FTLB文献的几个关键方面：循环推理，FTLB现象学和人口统计学的并发症，FTLB对TIC文献的影响，以及FTLB概念与功能障碍诊断标准的一致性问题。
结果：由于缺乏临床基准，FTLB的临床方法可能涉及循环推理。FTLB现象学和人口统计可能需要更多的工作，以确保缺乏偏见和对该患者组的适当描述，包括与抽搐的明确区分。FTLB讨论对更广泛文献的影响需要考虑。积极体征的验证可能有助于这两种努力，并为将FTLB纳入精神病学分类系统铺平道路。此外，需要解决同一患者体内FTLB和抽动共存的问题.
结论：可能需要更多的研究来全面确定FTLB的诊断并将其与抽搐区分开来。
