Functional neurological disorder has a dark past. Paralysis, spasms, numbness, vision loss, mental mist or difficulty in finding words are some symptoms that make it terrifying.
Imagine losing the ability to move members, walking or talking. He would probably recognize a medical emergency and went to the hospital.
Now imagine that at the hospital, doctors perform various exams and say, “Good news! All your exams are normal, brain images are clean and there’s nothing wrong. You can go home!” But in the face of the supposed good news, it continues to feel real, disabling, scary symptoms.
Unfortunately, this is the experience of many people with functional neurological disturbance.
What is functional neurological disturbance?
Neurological disorders are conditions that affect the functioning of the nervous system, which sends and receives messages between the brain and other parts of the body to regulate a wide range of functions, such as movement, speech, vision, thought and digestion.
In the eyes of those who have no medical formation, functional neurological disturbance can resemble other conditions, such as stroke, multiple sclerosis or epilepsy.
However, unlike these diseases, functional neurological symptoms are not due to physical damage or a pathological process in the nervous system. This means that disturbance does not appear in routine brain imaging or clinical testing.
Functional symptoms result, instead, a malfunction in information processing between multiple brain networks. Simply put: it is a problem with brain software, not the hardware.
Symptoms
Functional neurological disorder can cause a variety of diverse and variable symptoms, which often increases patient confusion and makes diagnosis difficult.
Symptoms may include paralysis or anommal movements, such as TORMORS, SPASSMOS e ticks. This can result in difficulties in marching or coordination of movement.
Sensory symptoms may include Numbness, anthill or Loss of vision.
Dissociative symptoms are also common, such as functional (seizure -like) crises and blackouts.
Some people have cognitive symptoms, such as mentle or Difficulty in finding words. Fatigue and chronic pain are often associated.
These symptoms may be severe and distressing and without treatment may persist for years. For example, some people with this disturbance are unable to walk and need a wheelchair for decades.
Diagnosis requires the identification of specific clinical signs and the exclusion of other diseases. This process should be performed by a neurologist or neuropsychiatrist with experience.
What is the prevalence?
Functional neurological disorder is one of the most common medical conditions observed in urgent services and external neurology consultations.
Affects about 10 to 22 people per 100,000 per year, which makes it more common than multiple sclerosis.
Nevertheless, it is often under-applied and misunderstood by health professionals, which leads to delays in the diagnosis and early treatment. Lack of knowledge contributes to the wrong perception that it is a rare condition, when it is actually one of the most common neurological disturbances.
Who is affected?
This condition can affect anyone, although it is more common in women and younger people. About two thirds of the sick are femalebut this gender difference tends to decrease with age.
Understanding the disturbance has evolved a lot in recent decades, but there is still much to find out. Several biological, psychological and social factors can predispose a person to the condition.
To genetics, traumatic life experiences, anxiety and depression can increase risk. Stressful life events, disease or physical injury may trigger or aggravate existing symptoms.
However, not all people with this disturbance have undergone significant trauma or stress.
The treatment
Without treatment, about half of the people with this condition remain in the same or get worse. However, with the help of experienced professionals, many people can recover quickly when treatment starts early.
There are no specific medications for this disturbance, but personalized rehabilitation oriented by experienced clinicians is recommended.
Some patients need a multidisciplinary team that may include physiotherapists, occupational therapists, speech therapists, psychologists and doctors.
It is also essential to provide rigorous information about the condition, as understanding and beliefs about disturbance play an important role in recovery. Correct information helps patients to have more realistic expectations, reduce anxiety and feel more skilled to participate in their recovery.
Treatment of coexistent conditions such as anxiety or depression may also be beneficial.
A dark past
The origins of this disturbance are deeply rooted in the sexist history of its pre-scientific predecessor- hysteria. The legacy of hysteria left a lasting negative mark, contributing to misogynistic prejudices in perception and treatment.
This historical context led to a persistent stigma, in which symptoms were often considered “psychological” and therefore devalued.
Women with functional symptoms often continue to face skepticism and rejection. In some cases, this leads to significant damage due to stigmatization, inadequate care and clinical mismanagement. Modern medicine has sought to correct these prejudices, recognizing functional neurological disturbance as a legitimate condition.
The lack of training of health professionals also contributes to stigma. Many clinicians report to have little knowledge or confidence in the management of this disturbance.
Fortunately, awareness, investigation and interest on this condition have increased in the last decade. Several therapeutic approaches are being tested, including Specialized physiotherapy, psychological therapies and noninvasive brain stimulation.
Organizations led by patients and support networks are making important progress in defending improvements in health systems, research and education. The goal is to unite patients, families, clinicians and researchers to establish a new standard of care worldwide.
