Functional Stroke Symptoms: A Narrative Review and Conceptual Model
| Autor: | Nicola O'Connell, Trudie Chalder, Anthony S. David, Abbeygail Jones |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Models Neurological Conceptual model (computer science) medicine.disease Psychophysiologic Disorders Stroke 03 medical and health sciences Psychiatry and Mental health 0302 clinical medicine Physical medicine and rehabilitation Intervention (counseling) medicine Humans Narrative review cardiovascular diseases 030212 general & internal medicine Neurology (clinical) Psychology 030217 neurology & neurosurgery Stroke services |
| Zdroj: | The Journal of Neuropsychiatry and Clinical Neurosciences. 32:14-23 |
| ISSN: | 1545-7222 0895-0172 |
| DOI: | 10.1176/appi.neuropsych.19030075 |
| Popis: | Stroke services have been reconfigured in recent years to facilitate early intervention. Throughout stroke settings, some patients present with functional symptoms that cannot be attributed to a structural cause. Emphasis on fast diagnosis and treatment means that a proportion of patients entering the care pathway present with functional symptoms that mimic stroke or have functional symptoms in addition to vascular stroke. There is limited understanding of mechanisms underlying functional stroke symptoms, how the treatment of such patients should be managed, and no referral pathway or treatment. Predisposing factors vary between individuals, and symptoms are heterogeneous: onset can be acute or insidious, and duration can be short-lived or chronic in the context of new or recurrent illness cognitions and behaviors. This article proposes a conceptual model of functional symptoms identified in stroke services and some hypotheses based on a narrative review of the functional neurological disorder literature. Predisposing factors may include illness experiences, stressors, and chronic autonomic nervous system arousal. Following the onset of distressing symptoms, perpetuating factors may include implicit cognitive processes, classical and operant conditioning, illness beliefs, and behavioral responses, which could form the basis of treatment targets. The proposed model will inform the development of theory-based interventions as well as a functional stroke care pathway. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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