Asserting a Functional Neurological Symptom Disorder with a Complementary Diagnostic Approach: A Brief Report.

Area of Science:

• Child and Adolescent Psychiatry
• Neuropsychiatry
• Psychosomatic Medicine

Background:

• Functional neurological symptom disorder (FNSD) is prevalent in adolescents.
• Diagnosis is complicated by diverse clinical presentations, evolving nosography, and overlap with somatic disorders.
• Illustrates diagnostic complexities through a unique case presentation.

Purpose of the Study:

• To highlight the diagnostic challenges in Functional Neurological Symptom Disorder (FNSD) among adolescents.
• To present an original diagnostic process for an atypical FNSD case.
• To underscore the limitations of current diagnostic systems for complex presentations.

Main Methods:

• Case presentation of an 11-year-old boy with fluctuating motor and sensory deficits.
• The patient exhibited paradoxical 'angelic' claims during altered physical states.
• Exclusion of organic, infectious, autoimmune, metabolic, and toxic etiologies.

Main Results:

• Comprehensive medical workup ruled out all organic causes.
• Standard psychiatric treatments (antidepressants, neuroleptics) were ineffective.
• Diagnosis of Functional Neurological Symptom Disorder (FNSD) was established.

Conclusions:

• The DSM-5-TR classification proved inadequate for this atypical FNSD case.
• A multidisciplinary diagnostic approach integrating biblical, psychoanalytical, and historical perspectives was necessary.
• Emphasizes the need for broader diagnostic frameworks for complex pediatric functional neurological disorders.