Functional neurologic disorder

Functional Neurologic Disorder
Specialty
SymptomsNumbness, weakness, non-epileptic seizures, tremor, movement problems, trouble speaking, fatigue
Usual onsetAges 20 to 40
Risk factors
Differential diagnosisMultiple sclerosis
Treatment
Medication

Functional neurologic disorder or functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement problems, sensory symptoms, and convulsions. As a functional disorder, there is, by definition, no known disease process affecting the structure of the body, yet the person experiences symptoms relating to their body function. Symptoms of functional neurological disorders are clinically recognisable, but are not categorically associated with a definable organic disease.[1][2]

The intended contrast is with an organic brain syndrome, where a pathology (disease process) which affects the body's physiology can be identified. Subsets of functional neurological disorders include functional neurologic symptom disorder (FNsD) (conversion disorder), functional movement disorder, and functional seizures. The diagnosis is made based on positive signs and symptoms in the history and examination during consultation of a neurologist.[3]

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 non-epileptic seizures.[4][5]

  1. ^ Stone J, Sharpe M, Rothwell PM, Warlow CP (May 2003). "The 12 year prognosis of unilateral functional weakness and sensory disturbance". Journal of Neurology, Neurosurgery, and Psychiatry. 74 (5): 591–596. doi:10.1136/jnnp.74.5.591. PMC 1738446. PMID 12700300.
  2. ^ Aybek S, Perez DL (January 2022). "Diagnosis and management of functional neurological disorder". BMJ. 376: o64. doi:10.1136/bmj.o64. PMID 35074803. S2CID 246210869.
  3. ^ Carey, Katie; Watson, Meagan (2003). Reset & Rewire: The FND Workbook for Kids & Teens. Houston, TX: Illustrated Nurse Press. p. 4. ISBN 9798218232047.
  4. ^ Lehn A, Gelauff J, Hoeritzauer I, Ludwig L, McWhirter L, Williams S, et al. (March 2016). "Functional neurological disorders: mechanisms and treatment". Journal of Neurology. 263 (3): 611–620. doi:10.1007/s00415-015-7893-2. PMID 26410744. S2CID 23921058.
  5. ^ Goldstein LH, Robinson EJ, Chalder T, Reuber M, Medford N, Stone J, et al. (March 2022). "Six-month outcomes of the CODES randomised controlled trial of cognitive behavioural therapy for dissociative seizures: A secondary analysis". Seizure. 96: 128–136. doi:10.1016/j.seizure.2022.01.016. PMC 8970049. PMID 35228117.