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"Functional neurological disorder"

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https://www.readbyqxmd.com/read/28566156/a-preliminary-investigation-of-sleep-quality-in-functional-neurological-disorders-poor-sleep-appears-common-and-is-associated-with-functional-impairment
#1
Christopher D Graham, Simon D Kyle
PURPOSE: Functional neurological disorders (FND) are disabling conditions for which there are few empirically-supported treatments. Disturbed sleep appears to be part of the FND context; however, the clinical importance of sleep disturbance (extent, characteristics and impact) remains largely unknown. We described sleep quality in two samples, and investigated the relationship between sleep and FND-related functional impairment. METHODS: We included a sample recruited online via patient charities (N=205) and a consecutive clinical sample (N=20)...
July 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28553554/a-case-of-sporadic-creutzfeldt-jakob-disease-presenting-as-conversion-disorder
#2
Nikhil Yegya-Raman, Rehan Aziz, Daniel Schneider, Anthony Tobia, Megan Leitch, Onyi Nwobi
Background. Creutzfeldt-Jakob disease is a rare disorder of the central nervous system. Its initial diagnosis may be obscured by its variable presentation. This case report illustrates the complexity of diagnosing this disease early in the clinical course, especially when the initial symptoms may be psychiatric. It offers a brief review of the literature and reinforces a role for consultation psychiatry services. Methods. PUBMED/MEDLINE was searched using the terms "Creutzfeldt-Jakob disease", "psychiatric symptoms", "conversion disorder", "somatic symptom disorder", "functional movement disorder", and "functional neurologic disorder"...
2017: Case Reports in Psychiatry
https://www.readbyqxmd.com/read/28449634/neuropsychiatric-associations-with-gender-illness-duration-work-disability-and-motor-subtype-in-a-u-s-functional-neurological-disorders-clinic-population
#3
Nassim Matin, Sigrid S Young, Benjamin Williams, W Curt LaFrance, Julie N King, David Caplan, Zeina Chemali, Jeffery B Weilburg, Bradford C Dickerson, David L Perez
The assessment of functional neurological disorders (FND) requires an interdisciplinary approach. The authors retrospectively reviewed charts for 100 outpatients with FND and used univariate and regression analyses to investigate neuropsychiatric associations with gender, illness duration, and work disability; secondary analyses evaluated for differences across motor FND subtypes. Men reported higher rates of cognitive complaints and functional weakness, whereas women endorsed increased past physical/sexual trauma...
April 28, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/28424653/disentangling-stigma-from-functional-neurological-disorders-conference-report-and-roadmap-for-the-future
#4
Karen S Rommelfanger, Stewart A Factor, Suzette LaRoche, Phyllis Rosen, Raymond Young, Mark H Rapaport
A multidisciplinary expert review of key issues and future directions from the conference "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms." On October 9 and 10, 2015, a conference entitled "Controversial labels and clinical uncertainties: psychogenic disorders, conversion disorder, and functional symptoms" was held at the Center for Ethics, Emory University, Atlanta, GA, USA. This conference brought together a select group of 30 distinguished thought leaders and practitioners, including ethicists, researchers, clinicians, humanities scholars, and advocates to discuss the unique challenges and controversies related to the diagnosis, treatment, and stigma for patients with what is currently recognized as functional ("psychogenic") neurological disorders...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28416565/cingulo-insular-structural-alterations-associated-with-psychogenic-symptoms-childhood-abuse-and-ptsd-in-functional-neurological-disorders
#5
David L Perez, Nassim Matin, Arthur Barsky, Victor Costumero-Ramos, Sara J Makaretz, Sigrid S Young, Jorge Sepulcre, W Curt LaFrance, Matcheri S Keshavan, Bradford C Dickerson
OBJECTIVE: Adverse early-life events are predisposing factors for functional neurological disorder (FND) and post-traumatic stress disorder (PTSD). Cingulo-insular regions are implicated in the biology of both conditions and are sites of stress-mediated neuroplasticity. We hypothesised that functional neurological symptoms and the magnitude of childhood abuse would be associated with overlapping anterior cingulate cortex (ACC) and insular volumetric reductions, and that FND and PTSD symptoms would map onto distinct cingulo-insular areas...
June 2017: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/28183377/impaired-awareness-of-motor-intention-in-functional-neurological-disorder-implications-for-voluntary-and-functional-movement
#6
K Baek, N DoƱamayor, L S Morris, D Strelchuk, S Mitchell, Y Mikheenko, S Y Yeoh, W Phillips, M Zandi, A Jenaway, C Walsh, V Voon
BACKGROUND: Functional neurological disorders (FNDs), also known as conversion disorder, are unexplained neurological symptoms unrelated to a neurological cause. The disorder is common, yet poorly understood. The symptoms are experienced as involuntary but have similarities to voluntary processes. Here we studied intention awareness in FND. METHOD: A total of 26 FND patients and 25 healthy volunteers participated in this functional magnetic resonance study using Libet's clock...
February 10, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28177082/5-ht2a-agonists-a-novel-therapy-for-functional-neurological-disorders
#7
Alexander Bryson, Olivia Carter, Trevor Norman, Richard Kanaan
Functional neurological disorders are frequently encountered in clinical practice. They have a poor prognosis and treatment options are limited. Their etiology is unknown, but leading theories propose a disturbance of somatic self-representation: the mind perceives dysfunction of a body region despite intact motor and sensory pathways. Central to this model is the concept of an abnormal top-down cognitive influence upon sensorimotor function. There is growing interest in the use of 5-HT2A agonists in the management of neuropsychiatric conditions...
May 1, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/27984257/preliminary-predictors-of-initial-attendance-symptom-burden-and-motor-subtype-in-a-us-functional-neurological-disorders-clinic-population
#8
David L Perez, Sigrid S Young, Julie N King, Anthony J Guarino, Barbara A Dworetzky, Alice Flaherty, Zeina Chemali, David Caplan, Bradford C Dickerson
BACKGROUND AND OBJECTIVE: Although many patients present with functional neurological symptoms (FNS), few US clinics offer specialized FNS care, and data on clinic attendees remain limited. We determined predictors of initial attendance, symptom burden, and FNS subtype in the first patients referred to our Functional Neurological Disorders Clinic for suspected FNS. METHODS: We reviewed the charts of 62 consecutive patients (46 women, 16 men). Regression analyses investigated predictors of keeping the first scheduled clinic appointment...
December 2016: Cognitive and Behavioral Neurology: Official Journal of the Society for Behavioral and Cognitive Neurology
https://www.readbyqxmd.com/read/27886517/organic-vs-functional-neurological-disorders-the-role-of-childhood-psychological-trauma
#9
Thanos Karatzias, Ruth Howard, Kevin Power, Florentina Socherel, Craig Heath, Alison Livingstone
Although the relationship between psychological trauma and medically unexplained symptoms (MUS) is well established, this relationship is less well understood in people with medically unexplained neurological symptoms. In the present study, we set out to compare people with functional neurological disorders, and organic neurological disorders, in terms of childhood and adulthood traumatic events, traumatic stress, emotional dysregulation and symptoms of depression and anxiety. We have hypothesised that those with functional neurological disorders would be more likely to report childhood and adulthood traumatic life events, traumatic symptomatology, emotional dysregulation and symptoms of anxiety and depression, compared to those with organic neurological disorders...
January 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/27719881/hypnosis-as-a-model-of-functional-neurologic-disorders
#10
REVIEW
Q Deeley
In the 19th century it was recognized that neurologic symptoms could be caused by "morbid ideation" as well as organic lesions. The subsequent observation that hysteric (now called "functional") symptoms could be produced and removed by hypnotic suggestion led Charcot to hypothesize that suggestion mediated the effects of ideas on hysteric symptoms through as yet unknown effects on brain activity. The advent of neuroimaging 100 years later revealed strikingly similar neural correlates in experiments matching functional symptoms with clinical analogs created by suggestion...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719880/dissociation-and-functional-neurologic-disorders
#11
REVIEW
R J Brown
Dissociation has been cited as a possible psychologic mechanism underpinning functional neurologic disorders (FND) since the 19th century. Since that time, changes in psychiatric classification have created confusion about what the term dissociation actually means. The available evidence suggests that it now refers to at least two qualitatively distinct types of phenomena: detachment (an altered state of consciousness characterized by a sense of separation from the self or world) and compartmentalization (a reversible loss of voluntary control over apparently intact processes and functions), as well as their underlying mechanisms...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719879/imaging-studies-of-functional-neurologic-disorders
#12
REVIEW
S Aybek, P Vuilleumier
Brain imaging techniques provide unprecedented opportunities to study the neural mechanisms underlying functional neurologic disorder (FND, or conversion disorder), which have long remained a mystery and clinical challenge for physicians, as they arise with no apparent underlying organic disease. One of the first questions addressed by imaging studies concerned whether motor conversion deficits (e.g., hysteric paralysis) represent a form of (perhaps unconscious) simulation, a mere absence of voluntary movement, or more specific disturbances in motor control (such as abnormal inhibition)...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719878/inpatient-treatment-for-functional-neurologic-disorders
#13
REVIEW
D T Williams, K Lafaver, A Carson, S Fahn
Patients with functional neurologic disorders present to clinicians with a variety of symptomatic manifestations, with various levels of severity, chronicity, and comorbidity, as well as with various degrees of past adversity, intrinsic resilience, and available external support. Clearly, treatment must be individualized. For those patients who have been severely or chronically impaired, especially if adequate prior outpatient treatments have failed, inpatient treatment that integrates the various modalities outlined here provides a rational route of rescue from a course otherwise potentially characterized by protracted dependence and disability...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719877/transcranial-magnetic-stimulation-and-sedation-as-treatment-for-functional-neurologic-disorders
#14
REVIEW
T R J Nicholson, V Voon
Functional neurologic disorder (FND), also known as conversion disorder, is common and often associated with a poor prognosis. It has been relatively neglected by research and as such there is a conspicuous lack of evidence-based treatments. Physical and psychologic therapies are the main treatment modalities, over and above reassurance and sensitive explanation of the diagnosis. However there are two other historic treatments that have seen a recent resurgence of interest and use. The first is electric stimulation, which was initially pioneered with direct stimulation of nerves but now used indirectly (and therefore noninvasively) in the form of transcranial magnetic stimulation (TMS)...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719876/neurophysiologic-studies-of-functional-neurologic-disorders
#15
REVIEW
M Hallett
Functional neurologic disorders are largely genuine and represent conversion disorders, where the dysfunction is unconscious, but there are some that are factitious, where the abnormality is feigned and conscious. Malingering, which can have the same manifestations, is similarly feigned, but not considered a genuine disease. There are no good methods for differentiating these three entities at the present time. Physiologic studies of functional weakness and sensory loss reveal normal functioning of primary motor and sensory cortex, but abnormalities of premotor cortex and association cortices...
2016: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719875/the-role-of-placebo-in-the-diagnosis-and-treatment-of-functional-neurologic-disorders
#16
REVIEW
K S Rommelfanger
Placebo therapy can produce meaningful, clinical relief for a variety of conditions. While placebos are not without their ethically fraught history, they continue to be used, largely covertly, even today. Because the prognosis for psychogenic disorders is often poor and recovery may be highly dependent on the patient's belief in the diagnosis and treatment regimen, some physicians find placebo therapy for psychogenic disorders compelling, but also particularly contentious. Yet placebos also have a long tradition of being used for provocative diagnosis (wherein placebo is used to elicit and/or terminate the symptoms as a way of diagnosing symptoms as "psychogenic")...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719874/nature-of-the-placebo-and-nocebo-effect-in-relation-to-functional-neurologic-disorders
#17
REVIEW
E Carlino, A Piedimonte, F Benedetti
Placebos have long been considered a nuisance in clinical research, for they have always been used as comparators for the validation of new treatments. By contrast, today they represent an active field of research, and, due to the involvement of many mechanisms, the study of the placebo effect can actually be viewed as a melting pot of concepts and ideas for neuroscience. There is not a single placebo effect, but many, with different mechanisms across different medical conditions and therapeutic interventions...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719873/hypnosis-as-therapy-for-functional-neurologic-disorders
#18
REVIEW
Q Deeley
Suggestion in hypnosis has been applied to the treatment of functional neurologic symptoms since the earliest descriptions of hypnosis in the 19th century. Suggestion in this sense refers to an intentional communication of beliefs or ideas, whether verbally or nonverbally, to produce subjectively convincing changes in experience and behavior. The recognition of suggestion as a psychologic process with therapeutic applications was closely linked to the derivation of hypnosis from earlier healing practices. Animal magnetism, the immediate precursor of hypnosis, arrived at a psychologic concept of suggestion along with other ideas and practices which were then incorporated into hypnosis...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719872/psychologic-treatment-of-functional-neurologic-disorders
#19
REVIEW
L H Goldstein, J D C Mellers
The management of patients with functional neurologic disorders poses many challenges. Psychologic treatments may well start at the point of delivery of the diagnosis, when careful explanations about the nature of the disorder have to be given to the patient and possibly also relatives/carers. Different conceptual models may assist in explaining the factors underlying the presentation, two of which (functional and dissociative) are briefly outlined here. The challenges for neurologists and psychiatrists of delivering a psychologic formulation as part of the diagnosis delivery are considered, along with the importance of clear communication between professionals involved in the patient's care...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/27719871/physical-treatment-of-functional-neurologic-disorders
#20
REVIEW
G Nielsen
Physical interventions are widely considered an important part of treatment of functional neurologic disorders (FNDs). The evidence base for physical interventions has been limited to a collection of case series, but the recent publication of several large cohort studies and a randomized controlled trial have provided stronger evidence to support its use. While the evidence for efficacy appears to be promising, details on how this should be delivered remain limited, perhaps due to the dominance of psychologically focused etiologic models...
2017: Handbook of Clinical Neurology
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