Affiliation:
1. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
2. Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
3. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
Abstract
BACKGROUND: The term “functional neurological disorder,” or “FND,” applies to disorders whose occurrence of neurological symptoms fluctuate with the patient’s attention to them. However, many other disorders that are not called “FND” nonetheless can also follow this pattern. Consequently, guidelines are unclear for diagnosing “FND.” OBJECTIVE: To review the neurological conditions that follow this pattern, but which have not so far been termed “FND,” to understand their overlap with conditions that have been termed “FND,” and to discuss the rationale for why FND has not been diagnosed for them. METHOD: A systematic review of the PubMed literature registry using the terms “fluctuation,” “inconsistency,” or “attention” did not yield much in the way of these candidate disorders. Consequently, this review instead relied on the author’s personal library of peer-reviewed studies of disorders that have resembled FND but which were not termed this way, due to his longstanding interest in this problem. Consequently, this approach was not systematic and was subjective regarding disease inclusion. RESULTS: This review identified numerous, diverse conditions that generally involve fluctuating neurological symptoms that can vary with the person’s attention to them, but which have not been called “FND.” The literature was unclear for reasons for not referring to “FND” in these instances. CONCLUSION: Most likely because of historical biases, the use of the term “FND” has been unnecessarily restricted. Because at its core FND is an attentionally-influenced disorder that can respond well to behavioral treatments, the field of neurological rehabilitation could benefit by extending the range of conditions that could be considered as “FND” and referred for similar behavioral treatments. Because the term “FND” has been viewed unfavorably by some patients and clinical practitioners and whose treatment is not implied, the alternative term attentionally-modifiable disorder is proposed.
Subject
Neurology (clinical),Rehabilitation,Physical Therapy, Sports Therapy and Rehabilitation
Reference287 articles.
1. Movement disorders in early MS and related diseases [review];Abboud,;Neurology Clinical Practice,2019
2. Positive clinical signs in neurological diseases - an observational study;Aboud,;Journal of Clinical Neuroscience,2019
3. You’ve made the diagnosis of functional neurological disorder: now what?;Adams,;Practical Neurology,2018
4. Le syndrome de dissociation automatico-volontaire du langage. (Physiopathologie de l’aphasie selon le principe de Baillarger-Jackson.);Alajouanine,;Semaine des Hôpitaux de Paris,1947
5. Post-stroke movement disorders: report of patients;Alarcón,;Journal of Neurology, Neurosurgery and Psychiatry,2004
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献