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Functional Neurological Disorder Presenting After Concussion: A Retrospective Case Series.

Ginger Polich1, Gaston Baslet1, Mary Angela O'Neal1

  • 1Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor).

The Journal of Neuropsychiatry and Clinical Neurosciences
|May 9, 2024
PubMed
Summary
This summary is machine-generated.

Functional neurological disorder (FND) symptoms can emerge after a concussion, persisting in some patients. Recognizing FND is crucial for accurate diagnosis and to avoid reinforcing negative beliefs about brain injury.

Keywords:
ConcussionFunctional Neurological DisorderFunctional SeizuresPersistent Postconcussion SymptomsRehabilitation (Neuropsychiatric)Traumatic Brain Injury

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Area of Science:

  • Neurology
  • Neuroscience
  • Psychiatry

Background:

  • Most concussion patients recover within weeks.
  • A significant minority experience persistent postconcussion symptoms.
  • Some persistent symptoms may indicate functional neurological disorder (FND).

Purpose of the Study:

  • To evaluate the relationship between persistent postconcussion symptoms and FND symptoms.
  • To characterize patients with FND following a concussion.

Main Methods:

  • Retrospective chart review of 50 patients.
  • Analysis of demographic and clinical data.
  • Confirmed diagnosis of FND with symptom onset post-concussion.

Main Results:

  • Patients with FND post-concussion often had baseline risk factors for both conditions.
  • Functional neurological symptoms varied widely (e.g., gait, seizures, weakness, sensory, speech, vision).
  • Symptom onset could be abrupt or insidious after the concussive event.

Conclusions:

  • Functional neurological symptoms can develop after a concussion.
  • FND is an important consideration in the differential diagnosis of post-concussion neurological symptoms.
  • Failure to recognize FND may negatively impact patient beliefs about their brain injury.