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Functional neurological disorder in children and young people: Incidence, clinical features, and prognosis
Kenneith Yong1, Richard F M Chin1,2,3, Jay Shetty1,2
1Department of Clinical Neurosciences, Royal Hospital for Children and Young People, Edinburgh, UK.
Insights
Functional neurological disorder (FND) in children is more common than previously thought, with nearly half of cases improving over time. However, outcomes may be less optimistic than in other studies.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Child Psychiatry
Background:
- Functional neurological disorder (FND) is a common neurological condition in children, but its incidence and outcomes in this population are not well-established.
- Understanding the characteristics and prognosis of FND in children is crucial for effective diagnosis and management.
Purpose of the Study:
- To determine the incidence, demographic, and clinical characteristics of functional neurological disorder (FND) in children.
- To investigate the symptom outcomes of pediatric FND at a regional center.
Main Methods:
- Prospective recruitment of children diagnosed with FND at a regional children's hospital over 36 months.
- Retrospective data extraction from electronic records for demographic, clinical, and follow-up information.
- Descriptive statistical analyses were employed to summarize findings.
Main Results:
- Ninety-seven children (5-15 years) met the FND case definition, with an annual incidence of 18.3 per 100,000 children.
- FND predominantly affected females (70%), with a median age of 13 years. Functional motor and sensory symptoms were most common.
- At 15 months follow-up, 49% of children reported symptom improvement or resolution; no specific prognostic factors were identified.
Conclusions:
- The incidence of FND in children at this regional center is higher than previously reported.
- Outcomes for pediatric FND may be less optimistic than suggested by some other studies, highlighting the need for further research and tailored interventions.
Aim:
To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children.
Method:
Children diagnosed with FND at a regional children's hospital were prospectively recruited by weekly active surveillance for 36 months. Demographic, clinical, and follow-up data were retrospectively extracted by review of electronic records. Descriptive statistical analyses were used.
Results:
Ninety-seven children (age range 5-15 years) met the case definition of FND (annual incidence 18.3 per 100 000 children). Children with FND were likely to be female (n = 68 [70%]) and older (median 13 years) with no difference in the Scottish Index of Multiple Deprivation (marker of socioeconomic status) compared with the general childhood population. Functional motor (41%) and sensory (41%) symptoms were most common; other somatic symptoms such as headache (31%) and pain (27%) were frequent. Self-reported psychiatric symptoms and infection/inflammation were the most common predisposing and precipitating factors respectively. At a median of 15 months follow-up, 49% of 75 children reported improvement or resolution of FND symptoms with no prognostic factors found.
Interpretation:
At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.
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