Functional neurological disorders in outpatient practice: An Australian cohort |
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| Affiliation: | 1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London, UK;2. Department of Neurology, University of Ljubljana, Slovenia;3. Movement Disorders Unit, Neurology Department, Hospital Universitari La Fe, Valencia, Spain;4. Department of Neuroscience and Sense Organs, “Aldo Moro” University, Bari, Italy;5. Department Clinical Neurosciences, School of Molecular and Clinical Medicine, University of Edinburgh, Edinburgh, UK;1. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King''s College London, De Crespigny Park, London, UK;2. Department of Neuropsychiatry, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, UK;1. Movement Disorders Division, Columbia University Medical Center and Department of Psychiatry, Columbia College of Physicians and Surgeons, New York, NY, USA;2. Movement Disorders Clinic, University of Louisville, Louisville, KY, USA;3. Departments of Clinical Neurosciences and of Rehabilitation Medicine, NHS Lothian and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;4. Department of Neurology, Columbia University Medical Center, New York, NY, USA;1. Departments of Clinical Neurosciences and of Rehabilitation Medicine, NHS Lothian and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;2. Department of Neurology, Princess Alexandra Hospital and School of Medicine, University of Queensland, Brisbane, Australia;1. Department of Clinical Neurosciences, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;2. Departments of Clinical Neurosciences and of Rehabilitation Medicine, NHS Lothian and Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK;3. Human Motor Control Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA |
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| Abstract: | Functional disorders are defined as neurological symptoms without causative organic pathology identified. They are a diverse and often neglected group of disorders. The aim of this was to determine the incidence and outcome of functional neurological disorders in an Australian neurology practice. Over a 17 month period, all patients presenting to a single outpatient neurology service were evaluated to determine the incidence and outcome of these disorders. A total of 884 patients were assessed and of these, 137 had a final diagnosis of functional neurological illness, equating to an incidence of 15% of all patients seen. Functional disorders were the third most common presentation overall. Patients with functional disorders were younger, more likely to be female and had a higher rate of current psychiatric comorbidity compared to other neurology patients. Sensory symptoms were the most common manifestation (48%) followed by limb weakness (37%) and psychogenic non-epileptic seizures (14%). Outcome information was available for 49% of patients at an average of 3 months follow-up. 45% had some improvement in their symptoms, 43% had static symptoms and 12% had worsening of symptoms. This study confirms the high incidence of functional disorders in outpatient neurology practice. Early improvement was seen in a substantial proportion of patients and is influenced by duration of symptoms. |
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| Keywords: | Conversion disorder Functional disorders Medically unexplained symptoms Psychiatry |
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