Nonepileptic attack disorder and functional movement disorder: A clinical continuum?

Area of Science:

• Neuroscience
• Psychiatry

Background:

• Nonepileptic attack disorder (NEAD) and functional movement disorder (FMD) are common functional neurological disorders.
• While NEAD and FMD have distinct referral pathways, they are often considered manifestations of a single conversion disorder.

Purpose of the Study:

• To compare the characteristics of patients with NEAD and FMD.
• To quantify the overlap between these patient groups and understand their relationship.

Main Methods:

• Retrospective review of clinical data from 146 patients with functional neurological disorders.
• Comparison of demographic and clinical characteristics, including somatic and psychiatric presentations, between NEAD and FMD groups.

Main Results:

• Most features showed no significant differences between NEAD and FMD patients.
• NEAD patients had an earlier age at onset, more acute onset, alterations of consciousness, and headaches.
• FMD patients reported higher rates of childhood abuse, mobility problems, and comorbid functional symptoms like dysarthria, dizziness, and weakness.

Conclusions:

• Despite differing presentations, NEAD and FMD may represent a clinical continuum.
• Findings have implications for diagnostic strategies and treatment approaches for functional neurological disorders.