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Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders, Espay et al, 2018

Discussion in 'Health News and Research unrelated to ME/CFS' started by Indigophoton, Jun 5, 2018.

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  1. Indigophoton

    Indigophoton Senior Member (Voting Rights)

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    This is a review article. I'm posting it for background reference, and because the description of FND signs in the paper doesn't look anything like ME (not to say that there isn't overlap, but this set of signs doesn't capture or describe ME. It sounds distinct and rather different).
    https://jamanetwork.com/journals/jamaneurology/fullarticle/2682656?
     
  2. alktipping

    alktipping Senior Member (Voting Rights)

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    this is just the distorted reasoning for empire building . tell me of any one doing extreme physical task who does not get shaking in the effected muscles . as far as facial tick are concerned there are potentially many reasons for them I had trigeminal nerve pain for nearly a decade that caused many tics . muscles that are not receiving enough energy for varying reasons will not continuously perform in the exact same way . and anyone who lives with chronic pain can tell you they adjust their posture to try and find a less painful position . I doubt that there is any good science behind any of these assumptions.
     
  3. Mithriel

    Mithriel Senior Member (Voting Rights)

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    It's not as if the brain is a complicated organ :banghead:

    If you have a shared set of symptoms in a group of people it suggests a possible pathology in the brain. Now, psychological treatments may help people cope and retraining and rehabilitation may be useful in the same way it is for strokes and MS. But to suggest it is psychogenic - oh sorry, my bad, functional, those pesky patients hate it being called psychological even if we know it is - is totally unscientific and inhumane as it leads to people being told they don't want to get better and being dumped from social and medical help when the proferred "treatments" make no difference.

    19th century medicine for the 21st.
     
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  4. Sean

    Sean Senior Member (Voting Rights)

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    19th? That advanced?
     
  5. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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  6. Andy

    Andy Committee Member & Outreach

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    And on this page, https://www.neurosymptoms.org/fatigue/4594358000, there is a link to Vogt's Recovery Norge, which probably tells us all we need to know about this site.
     
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  7. Trish

    Trish Moderator Staff Member

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  8. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    I have a hankering to turn this concept and organisation into a comedy tv show.

    Only thing is while the patients are variously diagnosed with these ailments week after week the comedy would be that the fearless/peerless medics would be the ones who exhibit all of the symptoms without any awareness. the patient of the week would be the more or less sane and sound counterpoint.

    Well, I think it would be funny. And saying so helps me stay sane when I read this drivel.

    Sorry, meant to explain that it is the explanation by the medics for the symptoms that is the disputed issue.
     
  9. rvallee

    rvallee Senior Member (Voting Rights)

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    Hmm hmm. That sounds nice. The model highlights stuff. And correlates things with other things.

    Except there is no evidence whatsoever that this describes anything in reality. "Explaining the unexplainable" really sets in the absurdity of this nonsense. Not part of this paper but that's the general idea, the "rousing reassurance" model. A belief system from top to bottom. Pseudoscience that is all about power, utterly indifferent to patient welfare or even minimal success, just the appearance of.

    Quite right that it's an idea straight from the 19th century. As well as the 18th, 17th and so on. Zero conceptual differences with shamanism, it just uses a different narrative but this would make a great religion.
     
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  10. Mithriel

    Mithriel Senior Member (Voting Rights)

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    Reading neurosymptoms.org is horrifying. Stating that all these diseases are caused by the nervous system not working and thinking that is an adequate explanation is breathtaking in its arrogance.

    Their "positive" signs of FND just mean that there is a set of problems they are misdiagnosing routinely. If you decide that spots are a sign of a functional disease then you will then think that infections are functional. It is circular reasoning. FND has these signs so these signs mean you have FND.

    The level of incompetence terrifies me. Have they never heard of glial cells, or channelopathies? Some cancers are well known for causing autoantibodies to parts of the nerve workings (the motor junction?), yet nothing.

    It also gives the impression that it is all clear cut, yet this is just another story. Many people with MS for instance were originally told they had a psychological illness before MRIs gave a reliable diagnosis. The same thing must be happening for those diseases where there is not a diagnostic test yet.

    There part about Complex Regional Pain Disorder illuminates their twisted thinking.

    "Some people reading this will wonder what CRPS is doing on a website for patients with functional symptoms. The reasons for this are discussed in this article.
    Popkirov S, Hoeritzauer I, Colvin L, Carson A, Stone J. Complex regional pain syndrome and functional neurological disorders: time for reconciliation. J Neurol Neurosurg Psychiatry. 2018; 0:jnnp-2018-318298. https://jnnp.bmj.com/content/early/2018/10/24/jnnp-2018-318298"

    from the abstract

    " FND is no longer assumed to be only the result of ‘conversion’ of psychological conflict but is understood as a complex interplay between physiological stimulus, expectation, learning and attention mediated through a Bayesian framework, with biopsychosocial predisposing, triggering and perpetuating inputs. Building on this new ‘whole brain’ perspective of FND, we reframe the debate about the ‘psychological versus physical’ basis of CRPS. We recognise how CRPS research may inform mechanistic understanding of FND and conversely, how advances in FND, especially treatment, have implications for improving understanding and management of CRPS."

    So they are using their similarities to their fake FND to say a physical problem is biopsychosocial
     
  11. rvallee

    rvallee Senior Member (Voting Rights)

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    This is some pretty advanced bullshit. It takes years to reach this level of making stuff up using words that sound half-convincing. The worst part is the same people who wrote this most likely commonly use conversion and hysteria when talking among themselves. They just learned to adapt their language to say one thing while meaning another. I hate that deceit is an essential part of this, completely dishonorable.

    Still as made-up as water having selective memory. Except the consequences of giving this official credibility make it all so much worse. Pretty ironic that the people who believe in this tripe look down on people who believe in healing crystals. In some ways I think it makes it worse.
     
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