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Long COVID Is Not a Functional Neurologic Disorder

Todd E Davenport1,2, Svetlana Blitshteyn3,4, Nicola Clague-Baker5

  • 1Department of Physical Therapy, University of the Pacific, Stockton, CA 95211, USA.

Journal of Personalized Medicine
|August 29, 2024
PubMed

Insights

Long COVID is not a functional neurologic disorder (FND). Evidence shows distinct pathophysiological mechanisms differentiate Long COVID from FND, preventing inappropriate diagnoses and treatments.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pathophysiology

Background:

  • Long COVID, a common sequela of SARS-CoV-2 infection, involves complex pathophysiological processes.
  • Some healthcare professionals incorrectly interpret Long COVID as a psychogenic or functional disorder.
  • This misinterpretation leads to diagnostic and therapeutic confusion for patients.

Purpose of the Study:

  • To provide a clinical and scientific rationale against classifying Long COVID as a functional neurologic disorder (FND).
  • To explore the historical links between neurasthenia, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and FND.
  • To differentiate Long COVID from FND based on clinical and neuroimaging findings.

Main Methods:

  • Reviewing the historical development of diagnostic constructs for neurasthenia-related conditions.
  • Examining the case definition criteria for functional neurologic disorder (FND).
  • Comparing clinical and neuroimaging findings in FND versus Long COVID.

Main Results:

  • Long COVID exhibits distinct pathophysiological mechanisms compared to functional neurologic disorder (FND).
  • Clinical and neuroimaging findings differentiate Long COVID from FND.
  • Historical diagnostic constructs show parallel but distinct evolutions.

Conclusions:

  • Classifying Long COVID as a functional neurologic disorder is inappropriate.
  • Differentiating pathophysiologic mechanisms and clinical findings are crucial for accurate diagnosis.
  • Mischaracterizing Long COVID as FND hinders appropriate patient care.

Keywords:
chronic fatigue syndromeconversion disorderdysautonomiaimagingmyalgic encephalomyelitisneurasthenianeurologyphysical examinationpost-COVID-19 condition (PCC)post-acute sequalae of COVID-19 (PASC)

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