Review Overall comorbidities in functional neurological disorder: A narrative review 2023 Carle-Toulemonde et al

Introduction
The importance to assess and include the frequent comorbidities in the personalised care management plan of patients with functional neurological disorders (FND) has arisen through the years. FND patients are not only complaining from motor and/or sensory symptoms. They also report some non-specific symptoms that participate to the burden of FND. In this narrative review, we aim to better describe these comorbidities in terms of prevalence, clinical characteristics and their variability depending on the subtype of FND.

Methods
The literature was searched for on Medline and PubMed. The search was narrowed to articles between 2000 and 2022.

Results
Fatigue is the most common symptom reported in relation to FND (from 47 to 93%), followed by cognitive symptoms (from 80 to 85%). Psychiatric disorders are reported in 40 to 100% FND patients, depending on the FND subtype (functional motor disorder [FMD], functional dissociative seizures [FDS]…) but also on the type of psychiatric disorder (anxiety disorders being the most frequent, followed by mood disorders and neurodevelopmental disorders). Stress factors such as childhood trauma exposure (emotional neglect and physical abuse predominantly) have also been identified in up to 75% of FND patients, along with maladaptive coping strategies. Organic disorders are commonly reported in FND, such as neurological disorders (including epilepsy in FDS [20%] and FMD in Parkinson's Disease [7%]). Somatic symptom disorders including chronic pain syndromes are frequently associated to FND (about 50%). To be noted, recent data also suggest a high comorbidity between FND and hypermobile Ehlers Danlos Syndrome (about 55%).

Conclusion
Put together, this narrative review highlights the high burden of FND patients, not only due to somatosensory alterations but also by considering the frequent comorbidities reported. Thus, such comorbidities must be taken into consideration when defining the FND personalised care management strategy for the patients.

Paywall, https://www.sciencedirect.com/science/article/abs/pii/S0013700623000866

 

Narrative reviews, so hot right now. We're gonna need narrative reviews of narrative reviews, stories about people writing stories about people. I guess that's the job here.

 

So not "high burden" of illness on patients but "high burden of FND patients" on what ? society ? medical services ? The authors are all apparently French so maybe something is lost in translation into English but this language looks grotesquely discriminatory.

 

Narrative is a disturbing trend in medicine. Wessely "If you want to convince someone- tell them a story"
(I paraphrase).

No surprise that Suzanne O'Sullivan did her MA in Creative Writing.