Functional Neurological Disorder (FND) is a condition that has long puzzled neurologists, bridging the divide between mind and body. With […]
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 »
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].
