Functional Neurological Disorder Flashcards
What is a functional neurological disorder (FND)?
Neurological symptoms or abnormal motor behaviours which cannot be explained by an organic cause
What is malingering?
Deliberately putting on symptoms to gain benefit e.g. money/housing from their or the state
What is munchausen’s syndrome?
The patient puts on symptoms to put on the sick role. Is common with adults who have spent a lot of time in hospital as a child
What is munchausen’s by proxy?
A caregiver is trying to gain attention through the person they are caring for e.g. parent is causing the symptoms in their child themselves
What is dystonia?
Changes in muscle tone
What are hyperkinetic conditions?
Uncontrolled movements of the limbs
Name the 11 common symptoms of functional neurological disorder?
o Tremor o Dystonia o Hyperkinetic conditions o Gait disorders/disturbance o Paresis o Pain o Loss of sensation o Hypersensitivity o Loss of concentration and memory o Seizures o Blindness/visual disturbance
What is paresis?
Anything from a mild loss of muscle strength to a complete loss of muscles activity
Name 8 pre-disposing factors of FND.
Anxiety, depression, personality disorder, dissociative disorders, obsessive compulsive disorder (OCD), previous history of FND, history of physical or sexual abuse, having a close relative with a functional disorder
What are factors that can trigger FND/what are the precipitating factors?
Physical injury/illness, panic attacks, migraines, infectious diseases/illness, stressful life events (losing a job, death of a loved one, breakdown of a relationship, changing schools (paediatric))
What does psychogenic mean?
It implies there is a primary psychological cause to FND
What does conversion disorder mean?
A term used to describe FND. It requires the identification of a defined psychological trigger
What factors can perpetuate FND? (6)
Non-acceptance of diagnosis Litigation Family dysfunction Financial benefits Provision of aids and equipment Provision of adaptive accommodation
In a patient how would you distinguish between a functional and organic tremor?
Functional tremor: patient will direct attention towards affected limb on examination, will show variable severity depending on attention towards affected limb (i.e. worse on examination, better with cognitive distraction techniques)
Organic tremor: tend not to direct attention to limb upon examination, severity remain unchanged with level of attention towards limb.
What is functional dystonia?
It is fixed abnormal postures of the limbs which are accompanied by severe pain
Often occurs after a peripheral injury
