Functional neurological symptoms

Stone, Jon

doi:10.7861/clinmedicine.13-1-80

Cited by 16 publications

(6 citation statements)

References 8 publications

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“…6,28 In the context of our results, this underscores the importance of a thorough screening for SSRDs in children and adolescents with PNES and is in line with the recommended management of functional neurologic symptoms in the adult population. 29 Neurodevelopmental disorders were observed in a substantial proportion of our cases of PNES compared to the ES and HC groups. Previous data based on small study samples have indicated even higher frequencies of ADHD than found in our results, with numbers as high as 29.1%.…”

Section: Discussionmentioning

confidence: 73%

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

et al. 2021

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Objective:Knowledge regarding psychiatric disorders in children and adolescents with psychogenic nonepileptic seizures (PNES) is limited. This study outlines the spectrum and risk of psychiatric disorders in childhood-onset PNES.Methods:A nationwide matched cohort study of children and adolescents with PNES aged 5-17 years at time of diagnosis between January 1, 1996 and December 31, 2014. Two matched comparison groups were included: children and adolescents with epilepsy (ES), and children and adolescents without PNES or epilepsy, termed healthy controls (HC). Outcomes were prevalent psychiatric disorders prior to index (i.e. date of diagnosis or corresponding date for HCs), and incident psychiatric disorders two years after index. Relative risks (RRs) were calculated and adjusted for potential confounders.Results:We included 384 children and adolescents with validated PNES, 1,152 with epilepsy, and 1,920 healthy controls. Among the PNES cases, 153 (39.8%) had prevalent psychiatric disorders and 150 (39.1%) incident psychiatric disorders. As compared to the epilepsy and healthy controls, children and adolescents with PNES had elevated risks of both prevalent psychiatric disorders (adjusted RRPNES/ES: 1.87, 95% CI: 1.59–2.21, adjusted RRPNES/HC: 5.54, 95% CI: 4.50–6.81), and incident psychiatric disorders (adjusted RRPNES/ES: 2.33, 95% CI: 1.92–2.83, adjusted RRPNES/HC: 8.37, 95% CI: 6.31–11.11). A wide spectrum of specific psychiatric disorders displayed elevated RRs.Conclusions:Children and adolescents with PNES are at higher risk of a wide range of psychiatric disorders as compared to children and adolescents with epilepsy and healthy controls. A careful psychiatric evaluation is warranted to optimize and individualize treatment.

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Section: Discussionmentioning

confidence: 73%

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

et al. 2021

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“…Only when all other possibilities are ruled out -that is, when no medical tests (blood tests, EEGs, fMRIs) show abnormalities -is the possibility considered that the patient may have symptoms of non-organic origin (e.g. Hallett, Stone, and Carson, 2016;Stone, 2013).…”

Section: The Phenomenon and The Diagnosesmentioning

confidence: 99%

Conversion disorder and/or functional neurological disorder: How neurological explanations affect ideas of self, agency, and accountability

Brenninkmeijer

2020

History of the Human Sciences

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An estimated 15% of patients seen by neurologists have neurological symptoms, such as paralysis, tremors, dystonia, or seizures, that cannot be medically explained. For a long time, such patients were diagnosed as having conversion disorder (CD) and referred to psychiatrists, but for the last two decades or so, neurologists have started to pay more serious attention to this patient group. Instead of maintaining the commonly used label of conversion disorder – which refers to Freud’s idea that traumatic events can be converted into deviant behaviour – these neurologists use the term functional neurological disorder (FND) and explain that the problems are due to abnormal central nervous system functioning. The situation that some patients with medically unexplained neurological symptoms are diagnosed with CD and treated by psychiatrists while others are diagnosed with FND and stay under the control of neurologists provides a unique case for analysing how neurological and psychological explanations affect subjectivity. In this article, I compare patient reports from English-language websites from the past 15 years to find out how minds, bodies, brains, and selves act and interact in the accounts of both patient groups. I conclude that the change in label from CD to FND has not only influenced ideas of medically unexplained disorders, but also affected ideas of the self and the body; of self-control and accountability.

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“…Kinderneurologen sind häufig mit funktionellen neurologischen Symptomen und Störungen konfrontiert [25,26]. Diese zeigen eine Reihe von typischen Merkmalen: ▪ nicht basierend auf identifizierbaren organischen Erkrankungen ▪ Symptome inkompatibel mit den Gesetzmäßigkeiten der Anatomie und Physiologie ▪ nicht kompatibel mit bekannter neurologischer Erkrankung ▪ Für den Patienten besteht eine erhebliche psychoemotionale Belastung und/oder Einschränkung der Funktionsfähigkeit [1].…”

Section: Begriffe Und Häufigkeitenunclassified

Psychosomatik in der Kinderneurologie

Merkenschlager¹,

Bernhard²,

Hiemisch³

et al. 2019

Kinder- und Jugendmedizin

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ZUSAMMENFASSUNGBasierend auf dem bio-psycho-sozialen Modell von Krankheit und Gesundheit beschäftigt sich die Neuropädiatrie mit dissoziativen und somatoformen Störungen des Kindes- und Jugendalters. Besonders die sog. Konversionsstörungen führen zu einer häufigen Inanspruchnahme des Kinderneurologen. Die nicht willentlich erzeugte Symptomatik basiert nicht auf einer identifizierbaren organischen Ursache und ist inkompatibel mit anatomischen und physiologischen Gesetzmäßigkeiten oder bekannten neurologischen Erkrankungen. Sie bedeuten für den Patienten und seine Familie eine erhebliche psychoemotionale Belastung und Funktionseinschränkung. Die Störungsbilder bergen das Risiko unnötiger und belastender Diagnostik und – mitunter invasiver – Therapie. Die Prognose psychotherapeutischer Interventionen ist umso günstiger je kürzer das Zeitintervall zwischen Manifestation und Diagnosestellung ist.

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Functional neurological symptoms

Cited by 16 publications

References 8 publications

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

Psychiatric Disorders in Children and Adolescents With Psychogenic Nonepileptic Seizures

Conversion disorder and/or functional neurological disorder: How neurological explanations affect ideas of self, agency, and accountability

Psychosomatik in der Kinderneurologie

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