Functional neurological disorder during the perinatal period: A case report

Functional neurological disorder (FND) is a rare neuropsychiatric illness that commonly presents to the medical setting as opposed to the psychiatric setting. FND is characterised by signs and symptoms affecting the voluntary motor or sensory function that cannot be explained by a specific neurological or general medical condition. FND in pregnancy and postpartum is rare. We report here a case of FND in a 32-year-old woman who presented with multiple medical problems during her perinatal period. She exhibited 'la belle indifference', history of vague unexplained medical symptomatology while all relevant investigations were normal. There were longstanding psychosocial and interpersonal difficulties with significant distress including multiple personal, marital, and family issues which stemmed from her childhood. This left her feeling inadequate as a mother to her infant. The diagnosis of FND was finalised by the multidisciplinary team consisting of a neurologist, physicians, and psychiatrists, based on longitudinal assessment. Psychological intervention for the patient included psychoeducation, supportive psychotherapy, stress management, and parental intervention. The key point in our management of the patient was the delivery of the diagnosis to help her understand the illness and treatment plan. For this patient, functional and psychological recovery is achievable with a good therapeutic alliance, early diagnosis of the illness, and the acceptance of her diagnosis.