Introduction Functional Neurological Disorder (FND) is a condition that affects the way the brain sends and processes signals, leading to […]
Understanding Functional Neurological Disorder (FND): A Comprehensive Guide for Patients Read Post »
Introduction Functional Movement Disorder (FMD) is a neurological condition where patients experience abnormal movements, such as tremors, jerks, or weakness,
Understanding the Pathophysiology of Functional Movement Disorder (FMD) Read Post »
Foreign Accent Syndrome (FAS) is an uncommon speech disorder where individuals develop a new, seemingly foreign accent in their native language. This review explores FAS within the contexts of functional neurological disorders (FND) and mild traumatic brain injuries (mTBIs).
In FNDs, FAS is often classified as a functional speech disorder, where no definitive structural brain lesions or neurological causes are identified. Cases suggest a psychogenic or functional origin, possibly triggered by psychological stress. Studies highlight that FAS in FNDs features inconsistencies and intermittency in speech patterns, which can occur even in the presence of structural brain damage.
In mTBIs, FAS can emerge without significant structural lesions visible on imaging. Reports indicate that even minor head injuries might lead to FAS, with functional or metabolic brain changes undetected by standard imaging techniques. For instance, abnormal functions in specific brain regions, such as the left dorsolateral inferior frontal gyrus and caudate nucleus, have been implicated.
Overall, the occurrence of FAS in both FNDs and post-mTBI contexts underscores the complexity of this speech disorder and the need for integrated diagnostic and therapeutic approaches. The studies reviewed suggest that functional and metabolic assessments, alongside behavioural interventions, are crucial for understanding and managing FAS effectively.
Foreign Accent Syndrome Read Post »
Functional Neurological Disorders (FND) present with symptoms that lack clear organic causes and mimic other neurological disorders. This overlap complicates diagnosis and significantly increases the likelihood of misdiagnosis. Traditionally considered a diagnosis of exclusion, the approach to FND has shifted towards inclusion based on specific clinical indicators. Despite advancements in diagnostic techniques and a growing understanding of FND’s pathophysiology, misdiagnoses remain common. These are often exacerbated by persistent misconceptions, such as viewing FND as solely psychological or suspecting symptom feigning. Misdiagnoses lead to inappropriate treatments, which are costly, potentially harmful, and psychologically damaging to patients. This paper reviews the challenges and impacts of FND misdiagnosis, emphasizes the importance of an informed, multidisciplinary approach for accurate diagnosis, and suggests advancements in neuroimaging and clinical education as critical tools for improvement.
Misdiagnosis in Functional Neurological Disorders (FND) Read Post »
he diagnosis of Functional Neurological Disorder (FND) represents a challenging but critical endeavor in neurology and psychiatry, requiring an integrated approach that transcends traditional diagnostic categories. This paper outlines a comprehensive framework for diagnosing FND, emphasizing the importance of direct clinical assessment, the strategic exclusion of other neurological and medical conditions, and the identification of characteristic positive signs. Contrary to being a diagnosis of exclusion, FND involves specific, identifiable signs such as Hoover’s sign, distractibility, and other non-physiological findings. These markers facilitate a positive diagnostic outcome, reinforcing that FND symptoms are genuine and rooted in functional impairments rather than structural abnormalities. Furthermore, the method of communicating the diagnosis to patients significantly affects their understanding, acceptance, and engagement in subsequent treatment, which can include physical therapy, psychotherapy, and medication. By providing a clear diagnostic pathway that incorporates both neurologic and psychiatric expertise, this paper aims to enhance the accuracy of FND diagnoses and improve patient outcomes through tailored, multidisciplinary care.
Diagnosis of functional neurological disorder Read Post »
Functional Neurological Disorders (FND) are characterized by neurological symptoms that are not explained by identifiable neurological disease. The diagnosis of FND is complex and requires a careful approach to avoid misdiagnosis, which can have significant legal and ethical implications. Misdiagnosis can lead to unnecessary treatments, psychological harm, and a lack of informed consent. Studies have shown that misdiagnosis rates for FND are similar to those for ‘organic’ neurological diseases, and the misdiagnosis of neurological diseases as FND occurs at a similar frequency. The challenge is compounded when patients have comorbid conditions, such as multiple sclerosis, where both conditions need to be treated. Ethical concerns include the potential for stigmatization of patients, the responsibility of healthcare professionals to correct public misinformation, and the importance of accurate communication of diagnoses. Legal concerns revolve around the accuracy of diagnosis, informed consent, and confidentiality. To address these concerns, enhanced training for healthcare providers, development of guidelines for media engagement, and multidisciplinary approaches to assessment and treatment are recommended. The goal is to ensure that patients receive accurate diagnoses and appropriate care, while healthcare providers navigate the ethical and legal landscape with due diligence.
Legal and Ethical Concerns in the Diagnosis of Functional Neurological Disorders Read Post »
Functional neurological disorders (FNDs) present a diagnostic challenge due to the absence of definitive biomarkers. This synthesis of current research explores the potential biomarkers for FNDs, aiming to enhance diagnostic accuracy and treatment efficacy. Cortisol levels have been investigated as state, trait, and prognostic biomarkers, reflecting the stress response and potential chronic alterations in hypothalamic-pituitary-adrenal axis functioning in FND patients[1]. Whole-body cryostimulation (WBC) has been proposed as an adjuvant treatment, with a case report demonstrating improvements in body composition, hematological biomarkers, and physical performance, suggesting physiological responses to WBC as potential biomarkers for treatment efficacy[2]. Vitamin B12 deficiency, often resulting from nitrous oxide misuse, has been identified as a consistent feature in hospital admissions for neurological disorders, indicating the importance of metabolic biomarkers in patient management[3]. Functional near-infrared spectroscopy (fNIRS) has been utilized to derive objective hemodynamic biomarkers, with machine learning algorithms demonstrating high accuracy in classifying neuropsychiatric disorders, underscoring the potential of fNIRS in the objective diagnosis of FNDs[4]. Additionally, glutamatergic dysfunction, neuroplasticity, and redox status in peripheral blood have been explored as potential biomarkers for motor conversion disorders, a subtype of FNDs[5]. This body of research signifies a shift towards identifying unfeignable biomarkers that could unravel the complex etiology of FNDs and guide more targeted interventions[6][7].
Functional Neurological Disorder (FND) presents a frontier of exploration in neurological and psychiatric disciplines, where symptoms manifest without clear organic causes. Neuroimaging, a pivotal tool in this exploration, offers a window into the brain’s workings, shedding light on how FND differs fundamentally from other disorders like malingering or feigning. This article delves into the sophisticated diagnostic techniques that delineate the nuanced presentations of FND. It highlights the ethical and clinical challenges faced by healthcare professionals in distinguishing genuine neurological symptoms from those artificially produced. With advancements in technology and a deepening understanding of the brain’s complex functions, we are better equipped to offer precise diagnoses and tailored treatments, paving the way for improved patient outcomes in FND management.
Distinguishing Functional Neurological Disorder from Malingering or Feigning Read Post »
