Functional Neurological Disorders Flashcards
1
Q
What is a functional symptom?
A
Medical symptoms with no known physical cause, arises from a problem in the functioning of the nervous system and not due to a structural or pathologically defined disease
2
Q
What are examples of functional symptoms?
A
- IBS in GI
- Chronic cough, brittle “asthma” in respiratory
- Chronic pelvis pain in gynaecology
- Non-cardiac chest pain, some palpitations in cardiology
3
Q
What parts of the history are important for functional symptoms?
A
- List all symptoms
- Ask about disability
- What is a typical day like
- Onset and course
- Timeline
- “When last did you feel well”
- “What happened with previous doctors”
- Dissociative symptoms
- Illness beliefs
- Social
- Work, money, the law, relationships
- History of abuse
- Wait till second consultation
- Get the old notes
4
Q
What part of the examination is important for functional symptoms?
A
- Inconsistency
- Positive functional signs
- Absence of signs of disease
- Example is a tremor that disappears with distraction
5
Q
What is Hoover’s test?
A
When pressure is felt the paretic (slight or partial paralysis) leg when the non-paretic leg is raised and no pressure is felt in the non-paretic leg when the paretic leg is being raised
6
Q
What investigations are done for functional symptoms?
A
- MRI brain scan
- 10-15% incidental findings
- Negative video EEG
- Functional MRI
7
Q
What is the management of functional symptoms?
A
- Explain what they do and do not have
- Make a positive diagnosis
- Indicate you believe them
- Explain that it is
- Common
- Potential to get better
- Self-help is key to recovery
- Consider depression/anxiety
- Antidepressants
- Referral
- Psychiatric
- Physical rehabilitation
- Psychological
- Cognitive behavioural therapy
- Support organisations and information
- Patient
- Family
- Friends
- Carers
- Charities
