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Screening for functional neurological disorders by questionnaire.

Oliver Shipston-Sharman1, Ingrid Hoeritzauer1, Mark Edwards2

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Summary
This summary is machine-generated.

The Edinburgh Neurosymptoms Questionnaire (ENS) shows promise for screening functional neurological disorders (FNDs), particularly for blackouts. However, its diagnostic value for other FND symptoms is limited.

Keywords:
Functional neurological disordersNeurological symptomsNeuropsychiatryScreening questionnaireSymptom count

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Area of Science:

  • Neurology
  • Psychiatry

Background:

  • Diagnostic screening for functional neurological disorders (FNDs) remains challenging.
  • Simple symptom counts are insufficient for FND discrimination.
  • Positive diagnostic features are increasingly recognized in face-to-face assessments.

Purpose of the Study:

  • To develop and pilot a self-completed questionnaire for FND screening.
  • To evaluate the utility of the Edinburgh Neurosymptoms Questionnaire (ENS) in clinical and research settings.

Main Methods:

  • The 30-item ENS survey was developed based on literature review and expert consensus.
  • The ENS was piloted on new general neurology clinic attendees.
  • Patients were classified based on neurologist impression of functional disorder contribution.

Main Results:

  • Individual symptom analysis showed reasonable diagnostic utility for blackouts (AUROC=0.94), weakness (AUROC=0.71), and memory problems (AUROC=0.74).
  • A multivariate model predicted functional classification with moderate utility (AUROC=0.83), high specificity (0.97), and moderate sensitivity (0.47).
  • Pain and blackout scores were the most accurate predictors of functional classification.

Conclusions:

  • The ENS demonstrates utility in differentiating functional blackouts but has limited diagnostic value for other FND types.
  • The study highlights the limitations of self-report tools in diagnosing the full spectrum of FNDs.