Functional Neurological Disorder-Old Problem New Perspective
Radu-Stefan Perjoc1,2, Eugenia Roza1,2, Oana Aurelia Vladacenco1,2
1"Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Insights
Functional neurological disorder (FND) is common in children. This review updates understanding of pediatric FND, highlighting new diagnostic criteria and multidisciplinary treatment approaches for better outcomes.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Psychiatry
Background:
- Functional neurological disorder (FND) is a prevalent condition in children and adolescents.
- Understanding of FND has evolved, necessitating updated knowledge on pediatric cases.
- Existing literature on pediatric FND is limited, requiring a focused review.
Purpose of the Study:
- To provide a comprehensive update on pediatric functional neurological disorder.
- To synthesize current knowledge on FND etiology, diagnosis, treatment, and prognosis in young individuals.
- To address the specific needs of the pediatric FND population.
Main Methods:
- Literature search of PubMed and SCOPUS databases.
- Review of 85 articles focusing on pediatric FND.
- Analysis of findings from functional and high-resolution MRI studies.
Main Results:
- Neuroimaging reveals abnormal connectivity and structural changes in pediatric FND patients.
- Diagnostic criteria now emphasize a rule-in approach, moving away from requiring a psychological factor.
- Multidisciplinary team support and clear diagnosis communication are key treatment components.
- Pediatric FND shows potential for better outcomes compared to adults.
Conclusions:
- Pediatric functional neurological disorder is a significant health issue with unique patient needs.
- Updated diagnostic and treatment strategies can improve outcomes for children and adolescents with FND.
- Further research is needed to fully elucidate pediatric FND.
Abstract:
Functional neurological disorder (FND) is a common issue in the pediatric population. The concept and our understanding of functional neurological disorders have changed over the past years, and new etiologic models and treatment plans have been explored. Knowledge about FND in the pediatric population, however, is lacking. The aim of this review is to provide an update on pediatric functional neurological disorder. We conducted a literature search of PubMed and SCOPUS databases and reviewed a total of 85 articles to gain insight into the current understanding of FND etiology, diagnosis, treatment, and prognosis in children and adolescents. Functional and high resolution MRI revealed abnormal connectivity and structural changes in patients with functional symptoms. The diagnostic criteria no longer require the presence of a psychological factor and instead focus on a rule-in diagnosis. Treatment of FND includes a clear communication of the diagnosis and the support of a multidisciplinary team. Although FND typically has a poor prognosis, better outcomes appear to have been achieved in children and young adults. We conclude that pediatric functional neurological disorder is a prevalent pathology and that this patient population has additional specific needs compared to the adult population.
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