Functional Neurological Disorder (FND) - articles, social media and discussion

Starts off referencing A practical review of functional neurological disorder FND for the general physician (2021, Clinical Medicine) —

And proceeds to describe the disease model per Stone and Carson. Includes a table detailing risk factors: psychologic stress; adverse childhood event; female biological sex; genetic factors; physical injuries. Also co-morbidities: depression, PTSD, chronic pain; irritable bowel syndrome; cluster B personality traits*.

However, despite all this initial framing, the main point of the paper is very reasonable. How to manage the dental care of patients with these symptoms. The FND formulation is irrelevant to this and mainly the example cases and discussion are around how to support the patient through a difficult dental procedure with special care and extra time and other accomodations. There is also an example of a particular dental problem termed oromandibular dystonia.

---
* Cluster B personality types are: antisocial, borderline, histrionic, narcissistic. (Noted without further comment.)

 

Chiari Malformation Type 1 In An Adolescent With Conversion Disorder (2023)

Which is a case report which describes a complete failure to fix the presenting problem. "The monthly follow-up of the case continues"

 

There was so much to keep track of while I was reading up on the history of ME that it was hard to recall who did what when, so I tried to make a timeline of everything that happened by year to help myself remember, but it became clear very quickly that it would be a bloated mess so I scrapped the idea. It gave me the idea to make a timeline of particularly relevant articles about FND listed in documents by topic and date though, both to see how the construct evolved and gained popularity over time and as an easy arguing resource given how many people online go to bat for FND as a useful diagnosis, particularly how many of them insist that it isn't a psychosomatic diagnosis. I didn't see anything like it on here, so maybe you'll get some use out of it. Let me know if there's any problems with the documents or if there's any useful changes I could make. I'll add any especially relevant articles that come out or I find.

Researchers/institutions etc. calling FND conversion disorder, hysteria etc.
https://docs.google.com/document/d/1RMyX6T-ZkVMPD0NyoErTo_EZOyFpVpVePC7VRNzmXac/

FND Diagnosis With Neurological Issues etc.
https://docs.google.com/document/d/1GbiMr5vLUXcZH8Pnc8t9ibM-1w12zkIdxFr-0fibUT4/

Acute Illnesses and Injuries at Onset of FND
https://docs.google.com/document/d/1w5N_ErP_-HIn9zuWKPAptrbU64j-Wx3Fzu3kQQEf0n8/

Especially bad/strange logic
https://docs.google.com/document/d/1AaSlWLTIvYK8uDADg52FPFCGNq4SLcoUa7UI8JrHUlo/

Admissions That There's No or Limited Evidence For Claims/Diagnostic Signs/Treatments
https://docs.google.com/document/d/1MIgdDMU-qraAI34Mk8BWwkKM079Haitz-JwAfj48xrQ/

Especially Egregious Cases
https://docs.google.com/document/d/1wcSkiEs8URMf_WVE_ymLLHKlZR5hlBR_gQaD7CDCQI0/

Somatoform Disorder, Parkinson's, Functional Parkinson’s etc.
https://docs.google.com/document/d/1zDjlMUL5CAXXlHGN3AafXKNEs9beKu5HrBz0BafEhnA/


Also, while doing a timeline of the whole ME controversy by date wouldn't work, timeline documents by subtopic would probably be manageable and I'd like to do it so that I can be sure I'm not forgetting anything important. Is there anything people would find particularly useful to have a dated list of to begin with? If not I'll probably start with the PACE trial controversy as a practice run given that there's so much written about it and so many summary articles already.

 

Gee, thanks! (I think!)

 

Nice articles here just here
Sone of the poisitive signs discused in the article can be false negatives false positives which can cloud judgement and show bias.
But they never give a theoretical point on why phych based disease can give physical symptoms

 

https://twitter.com/user/status/1685831199456186368



Just incredible. Researchers in neurology find that 88.1% of their pts have an identifiable ANS issue, & 27.1% have anti-gAChR antibodies signifying AAG, a supposedly v rare neuropathy.

All those pts were originally dxed with FND/"conversion disorder".

Response moved here

 

See also Pediatric de novo movement disorders and ataxia in the context of SARS-CoV-2 (2023)

FND proponents might wish to consider yet another renaming: perhaps to "idiopathic movement etc disorder". There's not going to be much left as "FND" once all the subgroup causes are demonstrated.

 

The way he writes, the way they all write about this issue, is maddening.

Where is the acknowledgment that emerging physical evidence could possibly invalidate the whole supposed theoretical basis for FND?

If the vague and expansive set of symptoms that they call FND (including common symptoms) can sometimes be caused by previously undiscovered physical abnormalities that completely destroys the software analogy they like to use.

They can’t have it both ways. It’s either software problems caused by magic beams from dimension X or mental trauma or it’s a, y’know, hardware problem - one that you couldn’t immediately detect with your crude tests and even cruder, short-hand and short-cut filled diagnostic approach.

 

The mechanism(s) of action in FND is just presented as a black box. They say they don’t know what happens in the box.

Yet they project total confidence in their construct of FND. While simultaneously calling for further research.

 

Absolutely incorrigible.

 

Unfortunately, they really can. All of this should have been stopped a long time ago, but it keeps going because it's too embarrassing for the whole profession. In the end there will be only a few things left and there will still be loud insistence that it's still a massive thing, since they can now freely attribute it in parallel to anything that isn't fully biologically explained, which is almost everything. They call it a "functional overlay", where even with a diagnosis they can attribute symptoms to suit their fancy.

I still don't see any actual pushback from within the profession. It's not even dozens, there really isn't any at all. No speaking truth to power in a heavily regulated profession, it's a career-ender. All the pushing is in the wrong direction, into making things worse.

They painted themselves in a corner with psychosomatic ideology and are willing to keep ruining lives simply to avoid facing reality, they're completely in denial over the massive harm they're doing. Which, ironically, is a serious mental illness, errors of thinking and beliefs leading to harmful behavior. But who will diagnose the mentally ill mental illness doctors with a mental illness they can't recognize?

Only technology will pave the way out of this. Fortunately, it's going to happen within years. Without this, it could be going for decades more.

 

I came across this article sometime in the last 2 years while researching FND.

Functional Neurological Disorder – Pushing the boundaries of medical credibility?

I’m not sure what to do in terms of reproducing it here or quoting parts; I’m not sure of the usual approach here to sources, I’m out of practice with forum posting and I’m also not at my pc.

It’s worth reading. It was one of the few things that I ever read about FND and the attitudes of medical professionals towards it that ever gave me hope.

Should I just quote the whole thing? That gets more uptake.

 

No, please don't. From our Forum Rules,

"Rule 7: Do not violate copyright law
It is not permitted to post entire copyrighted articles or PDF files, but full abstracts from research papers may be quoted so long as the original source is credited or linked to. Under "fair use" doctrine, it is also permitted to quote sections of copyrighted material, but it should be the minimal amount necessary to support or illustrate your commentary regarding the content. Linking to sci-hub or other third-party sources is also permitted."

 

I wondered. Thanks.

 

TLDR: 12yo boy unable to attend school, with pre-existing FND diagnosis, presents with escalating seizure disorder. Previous MRI/EEG = no abnormality detected. Junior staff about to discharge "because FND" but consultant paediatrician says "hold", run more tests. They diagnose an immune-mediated pathology (maybe anti-NMDAR encephalitis??), start treatment and patient now lives normally and goes to school.