Functional Neruological Symptoms Flashcards
Functional symptoms in GI
IBS
Functional symptoms in endocrinology
Borderline TFTs
Functional symptoms in respiratory
Chronic cough
Brittle asthma
Functional symptoms in rheumatology
Fibromyalgia
Sometimes chronic back pain
Functional symptoms in gynaecology
Chronic pelvic pain
Some dysmenorrhoea
Functional symptoms in cardiology
Atypical/non cardiac chest pain
Some palpitations
Functional symptoms in infectious diseases
Post viral chronic fatigue (CFS/ME)
Functional symptoms in ENT
Globus
Functional dysphonia
What are functional symptoms?
A change in function rather than the structure of a system (blackouts, paralysis abnormal movements) and the symptoms are not explained by any disease
Signs of functional symptoms
Inconsistency Absence of signs and disease Eye movements; convergence spasm Tremor - disapprears with distraction , entrainment Paralysis - leg dragged - hip internally/externally rotated - give way weakness Fixed dystonia Complex regional pain after minor injury
What is Hoovers sign?
Shows functional weakness
Hip extension is weak when tested directly but hip extension is normal when the patient is asked to flex the opposite hip
What is abductor sign a sign of?
Functional weakness
Investigations of functional neurological symptoms
History Exam MRI brain Negative video EEG Functional MRI
What do you tell a patient with functional symptoms?
Explain what they do and dont have Indicate that you believe them Common Potential to get better Self help is the key to recovery Role of depression/anxiety Referral - Psychiatry - Physcial rehab - CBT Support from family friends etc
