Functional neurological disorders in outpatient practice: An Australian cohort

J Clin Neurosci. 2016 Jun;28:93-6. doi: 10.1016/j.jocn.2015.11.020. Epub 2016 Jan 2.

Abstract

Functional disorders are defined as neurological symptoms without causative organic pathology identified. They are a diverse and often neglected group of disorders. The aim of this was to determine the incidence and outcome of functional neurological disorders in an Australian neurology practice. Over a 17month period, all patients presenting to a single outpatient neurology service were evaluated to determine the incidence and outcome of these disorders. A total of 884 patients were assessed and of these, 137 had a final diagnosis of functional neurological illness, equating to an incidence of 15% of all patients seen. Functional disorders were the third most common presentation overall. Patients with functional disorders were younger, more likely to be female and had a higher rate of current psychiatric comorbidity compared to other neurology patients. Sensory symptoms were the most common manifestation (48%) followed by limb weakness (37%) and psychogenic non-epileptic seizures (14%). Outcome information was available for 49% of patients at an average of 3months follow-up. 45% had some improvement in their symptoms, 43% had static symptoms and 12% had worsening of symptoms. This study confirms the high incidence of functional disorders in outpatient neurology practice. Early improvement was seen in a substantial proportion of patients and is influenced by duration of symptoms.

Keywords: Conversion disorder; Functional disorders; Medically unexplained symptoms; Psychiatry.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Conversion Disorder / epidemiology
  • Female
  • Humans
  • Male
  • Medically Unexplained Symptoms*
  • Middle Aged
  • Nervous System Diseases / epidemiology*
  • Outpatients / statistics & numerical data
  • Somatoform Disorders / epidemiology*
  • Young Adult