Functional neurological disorder: new subtypes and shared mechanisms, 2022, Prof Mark Hallett, MD et al

[Mij]

Summary

Functional neurological disorder is common in neurological practice. A new approach to the positive diagnosis of this disorder focuses on recognisable patterns of genuinely experienced symptoms and signs that show variability within the same task and between different tasks over time.

Psychological stressors are common risk factors for functional neurological disorder, but are often absent. Four entities—functional seizures, functional movement disorders, persistent perceptual postural dizziness, and functional cognitive disorder—show similarities in aetiology and pathophysiology and are variants of a disorder at the interface between neurology and psychiatry. All four entities have distinctive features and can be diagnosed with the support of clinical neurophysiological studies and other biomarkers. The pathophysiology of functional neurological disorder includes overactivity of the limbic system, the development of an internal symptom model as part of a predictive coding framework, and dysfunction of brain networks that gives movement the sense of voluntariness. Evidence supports tailored multidisciplinary treatment that can involve physical and psychological therapy approaches.

https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(21)00422-1/fulltext

 

[Sean]

All four entities have distinctive features and can be diagnosed with the support of clinical neurophysiological studies and other biomarkers.

The pathophysiology of functional neurological disorder includes overactivity of the limbic system, the development of an internal symptom model as part of a predictive coding framework, and dysfunction of brain networks that gives movement the sense of voluntariness.

Evidence supports tailored multidisciplinary treatment that can involve physical and psychological therapy approaches.

Such certainty in the face of so much uncertainty.

 

[Mithriel]

I do love

Psychological stressors are common risk factors for functional neurological disorder, but are often absent.

It's like astrology. "Capricorns are fun and outgoing but shy and retiring. They like to sit quietly in the corner and observe others but there are often the leader in there social group"

 

[rvallee]

I do love

It's like astrology. "Capricorns are fun and outgoing but shy and retiring. They like to sit quietly in the corner and observe others but there are often the leader in there social group"

Maybe Virgos will have a good day. Maybe not.

"Ooooh that's so Virgos! So accurate and truuuuuuuuuuuue."

You can basically swap neurotic and this is basically 90% of FND/MUS. It "may" be true. Or not. No one can tell, but they'll say it anyway.

 

[Sean]

Such certainty in the face of so much uncertainty.

Seems relevant:

It’s a trait best seen in the eager pub quizzer – a tendency to leap to an answer without a shadow of a doubt.

Now researchers have suggested that while people who have little difficulty making decisions are more confident in their choices, they are no more accurate than those who feel more torn.

https://www.theguardian.com/science...ve-people-no-more-accurate-than-self-doubters

https://pubmed.ncbi.nlm.nih.gov/35648760/