Persisting Symptoms After Concussion and Functional Neurological Disorder: Points of Intersection

Area of Science:

• Neurology
• Psychiatry
• Rehabilitation Medicine

Background:

• Persistent symptoms after concussion (PSaC) and functional neurological disorder (FND) present complex clinical challenges.
• Heterogeneous presentations and fragmented care pathways complicate management for both PSaC and FND.

Purpose of the Study:

• To review the intersections between PSaC and FND.
• To provide guidance for diagnosing and managing patients with overlapping features of PSaC and FND.
• To explore how integrating FND principles can enhance concussion care.

Main Methods:

• Literature review focusing on pathophysiology, illness beliefs, rehabilitation, and treatments for PSaC and FND.
• Analysis of diagnostic and management strategies applicable to both conditions.
• Examination of psychosocial factors influencing recovery.

Main Results:

• Identified key points of intersection in pathophysiology, illness beliefs, and rehabilitation models.
• Provided guidance on differential diagnosis, history-taking, examination, and communication for PSaC and FND.
• Highlighted the impact of patient expectations and healthcare interactions on recovery.

Conclusions:

• Integrating FND principles into concussion care can lead to more accurate case formulation.
• Individualized rehabilitation pathways can be supported by applying FND management strategies to PSaC.
• Improved understanding of shared features can enhance clinical practice for both conditions.