BMJ Neurology Topic Collection: "Advances in Functional Neurological Disorder", 2023

[SNT Gatchaman]

For some recent papers on foreign accent syndrome, see this post.

 

[Dx Revision Watch]

Depending on how science pans out, it may be possible in the future to request consideration of secondary or tertiary parenting for the 8E49 categories, so these terms could also be listed under more than one chapter...

I meant to add to this post that in 2015, when I was speaking to the WHO's Dr Robert Jakob, he mentioned that there had been some discussion about whether the ICD-10 G93.3 legacy categories might be considered for assigning a secondary parent for ICD-11. He would not disclose which chapters had been discussed as potential secondary parents but stressed that the WHO had no proposal to classify the terms under the Mental and behavioural disorders chapter.

During the development process, Prof Peter D White had lobbied the WHO for combining ICD-11's Mental, behavioural or neurodevelopmental disorders chapter with the Diseases of the nervous system chapter. That was rejected, too.

 

[Arvo]

The whole shit show is a giant rhetorical mirage.

I really like that description, fitting.

 

[Andy]

"Expanding the diagnostic criteria for FND: can fibromyalgia, irritable bowel, ‘post-concussion syndrome’ chronic fatigue syndrome all have the same pathophysiological basis? Should the DSM/ICD criteria be updated?"

And there is the answer to the question, why did do many FND 'experts' sign the recent opposition to the revised NICE guidelines?

It looks like us noticing has been itself noticed as the page now reads, "Expanding the diagnostic criteria for FND: can nociplastic pain, irritable bowel, ‘post-concussion syndrome’, persistent fatigue all have the same pathophysiological basis? Should the DSM/ICD criteria be updated?". I guess that they want to keep their true intentions hidden for as long as possible.

 

[Sean]

...can nociplastic pain, irritable bowel, ‘post-concussion syndrome’, persistent fatigue all have the same pathophysiological basis?

Again, how can a functional disorder have a pathophysiological basis?

If it does, then it is not functional. It is physiological. That is what basis means.

Functional is defined by its advocates as not having an underlying physiological/structural cause.

It can't be both, no matter how slippery the sophistry.

 

[Sid]

This interest in FND has accelerated,

Translation: 'We have been flooding any journal foolish enough to publish endless repeats of our bogus claims.'

It's the same 5 people flooding journals with the same article rewritten 100 times.

 

[Peter T]

It's the same 5 people flooding journals with the same article rewritten 100 times.

We are also seeing the creation of some at least FND specialist physiotherapists, speech & language therapists, etc, who then report their interventions as examples of good practice for more generalist clinicians to follow. This is part of establishing a pro FND clinical culture over and above the press of weak research papers and opinion pieces.