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Functional Neurological Disorders: A Comprehensive Review.

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Functional neurological disorders (FNDs) present with symptoms inconsistent with neurological conditions. Early diagnosis using positive clinical signs and multidisciplinary management are crucial for patient well-being.

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Area of Science:

  • Neurology
  • Neuroscience

Background:

  • Functional neurological disorders (FNDs) involve symptoms not explained by recognized neurological conditions.
  • Historically, understanding of FNDs has evolved significantly, from supernatural attributions to current neurocircuitry dysfunction models.
  • FNDs represent a substantial portion of neurological consultations, highlighting the need for accurate diagnostic approaches.

Purpose of the Study:

  • To review the evolution of FND understanding and terminology.
  • To outline key clinical signs for diagnosing various FND subtypes.
  • To emphasize the importance of positive diagnostic signs in FND management.

Main Methods:

  • Review of historical and current literature on Functional Neurological Disorders.
  • Categorization of FNDs into specific subtypes (e.g., functional limb weakness, seizures, movement disorders).
  • Identification and discussion of key clinical diagnostic clues for each FND subtype.

Main Results:

  • FNDs encompass diverse presentations including functional limb weakness, seizures, movement, gait, pseudosyncope, and cognitive dysfunction.
  • Positive clinical signs are essential for confident FND diagnosis, moving beyond a diagnosis of exclusion.
  • Early identification of positive signs aids in judicious investigation and timely management.

Conclusions:

  • Accurate diagnosis of FNDs relies on identifying specific positive clinical signs.
  • A multidisciplinary approach, including communication, psychiatric comorbidity management, and tailored therapy, is vital for effective FND management.
  • Continued research into neurocircuitry dysfunction is ongoing for these complex disorders.