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Functional neurological disorders - acute presentations and management

Cock, HR; Edwards, MJ (2018) Functional neurological disorders - acute presentations and management. Clinical Medicine, 18 (5). pp. 414-417. ISSN 1470-2118 https://doi.org/10.7861/clinmedicine.18-5-414
SGUL Authors: Cock, Hannah Rutherford Edwards, Mark John James

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Abstract

Functional neurological disorders (FND) are common and associated with significant morbidity and healthcare costs. Patients with FND often present acutely, particularly with dissociative seizures (resembling epilepsy) or persistent weakness resembling a stroke. History and careful observation and examination are critical to diagnosis, as investigations will often be normal or non-contributory. The nature of convulsive movements in dissociative seizures often differs from that in epilepsy, and long duration of individual events, waxing and waning, closed eyes and high reported frequency in an apparently well individual are all suggestive. In those with stroke-like episodes, demonstration of normal power even briefly (eg Hoover's sign, ‘give way’ weakness) together with distractability are positive physical features indicating a functional disorder. A positive diagnosis and clear non-judgemental explanation, backed up by reliable information sources associated with prompt onward referral to a neurologist can greatly reduce distress and ultimately improve outcomes.

Item Type: Article
Additional Information: © Royal College of Physicians 2018. All rights reserved.
Keywords: 1103 Clinical Sciences, General Clinical Medicine
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Academic Structure > Institute of Medical & Biomedical Education (IMBE) > Centre for Innovation & Development in Education (INMEID)
Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: Clinical Medicine
ISSN: 1470-2118
Dates:
DateEvent
1 October 2018Published
15 August 2018Accepted
Publisher License: Publisher's own licence
URI: https://openaccess.sgul.ac.uk/id/eprint/110094
Publisher's version: https://doi.org/10.7861/clinmedicine.18-5-414

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