+1 credit
| Version | Summary | Created by | Modification | Content Size | Created at | Operation |
|---|---|---|---|---|---|---|
| 1 | Sirius Huang | -- | 2099 | 2022-11-21 01:40:29 |
Video Upload Options
A functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts. In the past, the brain of a patient with functional neurological symptom disorder was believed to be structurally normal, but functioning incorrectly. Patients with FND were marginalized for much of the 20th century, with limited clinical and neuroscientific interest. Converging evidence from several studies using different techniques and paradigms has now demonstrated distinctive brain activation patterns associated with functional deficits, unlike those seen in actors simulating similar deficits. New research has uncovered pathways in the brain’s white matter that may be altered in patients with functional neurological disorder (FND). The new findings advance current understanding of the mechanisms involved in this disease, and offer the possibility of identifying markers of the condition and patients’ prognosis. Historically, other terms have been used to describe these symptoms. Symptoms of functional neurological disorders are clinically recognisable, but are not categorically associated with a definable organic disease. The intended contrast is with an organic brain syndrome, although the terms imply a level of certainty about causation that is often clinically unconfirmed. Subsets of functional neurological disorders include functional neurological symptom disorder (FNsD), conversion disorder, and psychogenic movement disorder/non-epileptic seizures. Functional neurological disorders are common in neurological services, accounting for up to one third of outpatient neurology clinic attendances, and associated with as much physical disability and distress as other neurological disorders. The diagnosis is made based on positive signs and symptoms in the history and examination during consultation of a neurologist (see below). Physiotherapy is particularly helpful for patients with motor symptoms (weakness, gait disorders, movement disorders) and tailored cognitive behavioural therapy has the best evidence in patients with dissociative (non-epileptic) attacks.
References
- Fiszman, A. & Kanner, A. M. in Gates and Rowan's Nonepileptic Seizures (eds. Schacter, S. & LaFrance Jr, W. C.) 3rd editio, 225–234 (Cambridge University Press, 2010).
- Henningsen, P. Medically Unexplained Physical Symptoms, Anxiety, and Depression: A Meta-Analytic Review. Psychosom. Med. 65, 528–533 (2003).
- Edwards, M. J.; Stone, J.; Lang, A. E. (2014). "From psychogenic movement disorder to functional movement disorder: It's time to change the name". Mov. Disord 29: 849–852. doi:10.1002/mds.25562. https://dx.doi.org/10.1002%2Fmds.25562
- Kranick, S. (2011). "Psychopathology and psychogenic movement disorders". Mov. Disord 26: 1844–1850. doi:10.1002/mds.23830. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=4049464
- Ludwig, Lea; Pasman, Joëlle A; Nicholson, Timothy; Aybek, Selma; David, Anthony S; Tuck, Sharon; Kanaan, Richard A; Roelofs, Karin et al. (April 2018). "Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies". The Lancet Psychiatry 5 (4): 307–320. doi:10.1016/S2215-0366(18)30051-8. http://discovery.ucl.ac.uk/10074178/1/David_Manuscript_Life_events_Jan18_clean_version.pdf.
- Stone, J. (2005). "Systematic review of misdiagnosis of conversion symptoms and 'hysteria'". BMJ 331: 989. doi:10.1136/bmj.38628.466898.55. https://dx.doi.org/10.1136%2Fbmj.38628.466898.55
- Stone, J.; Hallett, M.; Carson, A.; Bergen, D.; Shakir, R. (2014). "Functional disorders in the Neurology section of ICD-11: A landmark opportunity". Neurology 83: 2299–301. doi:10.1212/wnl.0000000000001063. https://dx.doi.org/10.1212%2Fwnl.0000000000001063
- Stone, J.; Sharpe, M.; Rothwell, P. M.; Warlow, C. P. (2003-05-01). "The 12 year prognosis of unilateral functional weakness and sensory disturbance" (in en). Journal of Neurology, Neurosurgery & Psychiatry 74 (5): 591–596. doi:10.1136/jnnp.74.5.591. ISSN 1468-330X. PMID 12700300. PMC 1738446. http://jnnp.bmj.com/content/74/5/591.
- Nielsen, G.; Stone, J.; Edwards, M. J. (2013). "Physiotherapy for functional (psychogenic) motor symptoms: a systematic review". J. Psychosom. Res. 75: 93–102. doi:10.1016/j.jpsychores.2013.05.006. https://dx.doi.org/10.1016%2Fj.jpsychores.2013.05.006
- Jordbru, A. A., Smedstad, L. M., Klungsoyr, O. & Martinsen, E. W. Psychogenic gait: a randomized controlled trial on effect on rehabilitation. Clin. Rehabil.
- McCormack, R. (2014). "Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study". J. Neurol. Neurosurg. Psychiatry 85: 895–900. doi:10.1136/jnnp-2013-305716. https://dx.doi.org/10.1136%2Fjnnp-2013-305716
- [([1])]
- Edwards, M. J. Functional neurological symptoms: welcome to the new normal. Pract. Neurol. 16, 2–3 (2016)
- "neurosymptoms.org". http://www.neurosymptoms.org/#/in-the-mind/4533053408. Retrieved 2016-02-07.
- "Neurological functional symptoms stepped care report". http://www.healthcareimprovementscotland.org/our_work/long_term_conditions/neurological_health_services/neurological_symptoms_report.aspx. Retrieved 2015-11-25.
- Stone, J. Functional neurological symptoms. J.R.Coll.Physicians Edinb. 41, 38–41 (2011)
- Tasca, Cecilia; Rapetti, Mariangela; Carta, Mauro Giovanni; Fadda, Bianca (2012-10-19). "Women And Hysteria In The History Of Mental Health". Clinical Practice and Epidemiology in Mental Health 8: 110–119. doi:10.2174/1745017901208010110. ISSN 1745-0179. PMID 23115576. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=3480686
- Webster, Richard. "Sigmund Freud: somatization, medicine and misdiagnosis". http://www.richardwebster.net/freudandhysteria.html. Retrieved 2016-02-21.
- "Functional neurologic disorders/conversion disorder". https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197.
- Wessely, Simon; White, Peter D. (2004-08-01). "There is only one functional somatic syndrome" (in en). The British Journal of Psychiatry 185 (2): 95–96. doi:10.1192/bjp.185.2.95. ISSN 0007-1250. PMID 15286058. http://bjp.rcpsych.org/content/bjprcpsych/185/2/95.full.pdf.
