Functional Neurological Disorder Presenting After Concussion: A Retrospective Case Series.

Autor: Polich G; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor)., Baslet G; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor)., O'Neal MA; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor)., Gupta R; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor)., Raynor LG; Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston (Polich); Departments of Physical Medicine and Rehabilitation (Polich), Psychiatry (Baslet, Raynor), and Neurology (O'Neal), Brigham and Women's Hospital, Boston; Department of Psychiatry, Brigham and Women's Faulkner Hospital, Boston (Gupta); Department of Psychiatry, Naval Medical Center San Diego, San Diego (Raynor).
Jazyk: angličtina
Zdroj: The Journal of neuropsychiatry and clinical neurosciences [J Neuropsychiatry Clin Neurosci] 2024 Fall; Vol. 36 (4), pp. 333-339. Date of Electronic Publication: 2024 May 09.
DOI: 10.1176/appi.neuropsych.20230154
Abstrakt: Objective: Although a majority of individuals recover from a concussion within weeks of the index injury, a substantial minority of patients report persistent postconcussion symptoms. Some of these symptoms may reflect a diagnosis of functional neurological disorder (FND). The authors evaluated the relationship between persistent postconcussion symptoms and FND symptoms.
Methods: In this retrospective chart review, the authors characterized demographic and clinical information from 50 patients with a confirmed diagnosis of FND whose functional neurological symptoms started after a concussion.
Results: Patients who developed FND after a concussion had high rates of baseline risk factors for both persistent postconcussion symptoms and FND. After the concussive event, functional neurological symptoms presented abruptly or developed insidiously over time. Functional neurological symptoms ranged widely and included gait symptoms, seizures, speech and language symptoms, weakness, sensory symptoms, tremors, and vision and oculomotor symptoms.
Conclusions: Functional neurological symptoms can arise after a concussion. FND should be considered in the differential diagnosis of individuals presenting with neurological symptoms beginning after a concussion. By failing to recognize functional symptoms, clinicians may inadvertently reinforce negative health-related beliefs regarding a patient's injured brain.
Competing Interests: Dr. Polich has received funding from the Foundation for Physical Medicine and Rehabilitation to study rhythmic auditory stimulation for functional gait disorders. Dr. Baslet has received royalties from Oxford University Press and payment for lectures on functional neurological disorders. Dr. O’Neal has received royalties from Oxford University Press, Springer, and UpToDate and has served as a consultant to Crico and Teladocs. Dr. Gupta reports no financial relationships with commercial interests.
Databáze: MEDLINE