Functional Neurological Disorder: Diagnostic Pitfalls and Differential Diagnostic Considerations

Area of Science:

• Neurology
• Psychiatry

Background:

• Functional neurologic disorder (FND) is a clinical diagnosis.
• Diagnosis relies on identifying specific examination signs and semiological features.
• Certainty of diagnosis increases with multiple consistent FND features.

Purpose of the Study:

• To review common diagnostic pitfalls in functional neurologic disorder (FND).
• To discuss differential diagnoses for FND, considering both neurologic and psychiatric conditions.
• To provide guidance based on FND symptom subtypes and patient presentation.

Main Methods:

• This is a perspective article.
• It reviews diagnostic pitfalls categorized by FND symptom subtype.
• It discusses differential diagnostic considerations.

Main Results:

• Diagnostic pitfalls vary significantly based on FND symptom subtype and individual patient presentation.
• Accurate diagnosis requires careful observation of positive examination signs.
• Distinguishing FND from other neurologic and psychiatric conditions is crucial.

Conclusions:

• Recognizing and avoiding diagnostic pitfalls is essential for accurate FND diagnosis.
• Differential diagnosis should encompass both organic neurologic and psychiatric disorders.
• A thorough clinical evaluation with attention to specific signs improves diagnostic certainty.