Functional Neurological Disorder in the Emergency Department, 2021, Finkelstein, Stone et al

[Andy]

"ABSTRACT
We provide a narrative review of functional neurological disorder (FND, or conversion disorder) for the emergency department (ED). Diagnosis of FND has shifted from a ‘rule‐out’ disorder to one now based on the recognition of positive clinical signs, allowing the ED physician to make a suspected or likely diagnosis of FND. Pubmed, Google Scholar, academic books, and a hand search through review article references were used to conduct a literature review. We review clinical features and diagnostic pitfalls for the most common functional neurologic presentations to the ED, including functional limb weakness, functional (non‐epileptic) seizures, and functional movement disorders. We provide practical advice for discussing FND as a possible diagnosis and suggestions for initial steps in workup and management plans."

Paywall, https://onlinelibrary.wiley.com/doi/10.1111/acem.14263

 

[Mithriel]

 

[Sid]

That horrifying moment when the ER wheels out a liaison psychiatrist to deliver the news that there is, in fact, nothing wrong with you.

 

[Sean]

Their grab for veto power over who gets to see a real doctor enters its final big push.

This is going to be a cruel and totally avoidable catastrophe.

And nobody will be held to account for it.

 

[Arnie Pye]

Diagnosis of FND has shifted from a ‘rule‐out’ disorder to one now based on the recognition of positive clinical signs, allowing the ED physician to make a suspected or likely diagnosis of FND.

What is this going to do to the death rate in women, I wonder, where death is caused by an entirely treatable condition?

 

[alktipping]

once some one is given this diagnosis they will never be treated for anything ever again just fobbed of with this lie . just how many people will have to die for a proper inquiry into this financially motivated fraud .

 

[Sid]

These sorts of papers are designed to give doctors even more justification to dismiss things as anxiety and hysteria. Once you have these lies on your chart, it's pretty much the kiss of death. A friend of mine had unexplained abdominal pain for years which was diagnosed as psychosomatic. A few years later she developed gallstones and it was almost impossible to get a simple ultrasound because the moronic doctor dismissed every complaint as psychosomatic and "you've already had all these investigations".

 

[alktipping]

These sorts of papers are designed to give doctors even more justification to dismiss things as anxiety and hysteria. Once you have these lies on your chart, it's pretty much the kiss of death. A friend of mine had unexplained abdominal pain for years which was diagnosed as psychosomatic. A few years later she developed gallstones and it was almost impossible to get a simple ultrasound because the moronic doctor dismissed every complaint as psychosomatic and "you've already had all these investigations".

this also happened to a young male friend of my younger brother his symptoms started a few months after his fathers death he was in agony for a long time till he was rushed into a hospital that had no medical notes on him he had several large kidney stones . the doctor of course blamed his pain on emotions based solely on the recent death of his father .

 

[Sean]

These sorts of papers are designed to give doctors even more justification to dismiss things as anxiety and hysteria. Once you have these lies on your chart, it's pretty much the kiss of death.

Literally...

Friend of mine died a few years ago from bowel cancer in their late-30s, after the symptoms being repeatedly dismissed by doctors in leading hospitals, and the correct diagnosis being delayed until it was too late.

Nobody here will be surprised to learn my friend was female.

 

[Mithriel]

The problem is that FND is treated as one disorder which mimics everything you can think of from seizures, IBS to strokes and kidney stones so that it does not matter what your symptoms are, if your arm drops when they examine you that is it.

 

[Arnie Pye]

A friend of mine had unexplained abdominal pain for years which was diagnosed as psychosomatic. A few years later she developed gallstones and it was almost impossible to get a simple ultrasound because the moronic doctor dismissed every complaint as psychosomatic and "you've already had all these investigations".

I've just read the following anecdote on another forum, written by a woman, naturally :

Some time ago I was told by a gastroenterologist that it was my responsibility to feed myself properly. I had lost a lot of weight .

At the time and soon to be discovered I had a tumour causing blockage in my bowel.

It caused me much harm emotionally .

 

[Amw66]

Tweet this morning
Retweeted by @PhysiosforME

Can we have some clarity.
This is a steamroad roller in ED / A andE

Either FND is conversion disorder is hysteria or its not

 

[Andy]

Retweeted by @PhysiosforME

I don't see this on their Twitter timeline?

 

[Amw66]

I don't see this on their Twitter timeline?

I was sure Nicola had liked it, however it appears not - pre coffee concnetration issue - apologies for confusion caused.

 

[Andy]

I was sure Nicola had liked it, however it appears not - pre coffee concnetration issue - apologies for confusion caused.

I've just spotted that Nicola from @PhysiosforME retweeted it, so I'd imagine that's what you saw. Hopefully it didn't indicate endorsement, considering the likely caused by the ideas in this paper.