Review Functional neurological disorder in pregnancy, labour and the postpartum period: systematic review 2024 Cabreira, Carson, Stone et al

Abstract

Aims and method
Functional neurological disorder (FND) most often presents in women of childbearing age, but little is known about its course and outcomes during pregnancy, labour and postpartum (the perinatal period). We searched MEDLINE, PsycInfo and Embase combining search terms for FND and the perinatal period. We extracted data on patient demographics, subtype of FND, timing of symptom onset, comorbidities, medications, type of delivery, investigations, treatment, pregnancy outcomes and FND symptoms at follow-up.

Results
We included 36 studies (34 case reports and 2 case series) describing 43 patients. Six subtypes of FND were identified: functional (dissociative) seizures, motor weakness, movement disorder, dissociative amnesia, speech disorders and visual symptoms. New onset of perinatal FND was more common in the third trimester and onwards. Some women with functional seizures were exposed to unnecessary anti-seizure prescriptions and intensive care admissions.

Clinical implications
Prospective studies are urgently needed to explore how FND interacts with women's health in the perinatal period.

Open access, https://www.cambridge.org/core/jour...matic-review/7D0C19F8CB0F0112A4EA57990054D917

 

Sometimes feels like Carson & Stone are the new Wessely & Sharpe. Is history repeating?

 

They Are

Didn't Stone and Carson train under Sharpe during his years in Edinbugh?
From 1997 to 2011 Sharpe was a professor of psychological medicine at the University of Edinburgh.

 

Yeah I'm pretty sure there are strong links between all four. Carson has had peripheral involvement with ME/CFS.

 

We really need an in depth study of the psychosocial factors present in clinicians diagnosing and researchers promoting FND.

I am not denying that some groupings of patients with an FND diagnosis represent a meaningful clinical entity, but I doubt the proponents of FND empire building and automatic psychotherapy are meaningfully helping such patients.

 

They are very very good at identifying markets and funding .
Womens Health has had a lot of publicity, has had the attention of the Scottish government who have a women's health plan in development / place after consultation.
This is the start of a bid for a bit of the pie

https://www.gov.scot/news/womens-health-plan/

 

So this is the social but what about the psychological? (Note please avoid breaching site rules.)

 

ETA

Hormones throw up issues throughout pregnancy and post partum .
Feeding into many weird loops .
FND can only divert research into dealing with root cause .
https://www.todaysparent.com/pregna...-hormones-affect-your-body-in-each-trimester/

 

Well of course they would wouldn’t they .. what a time to suggest maybe its the emotions (and hormones)