Postural orthostatic tachycardia syndrome and other common autonomic disorders are not functional neurologic disorders, 2024, Blitshteyn

Pretty interesting opinion piece. Final author listed is Dr. Blair Grubb.

here is an quote from it (my bolding):

In summary, diagnostic criteria for POTS and other common autonomic disorders have been established and are vastly different from the diagnostic criteria of FND (Table 1) (6)(7)(8)(9).Pathophysiology of and therapies for POTS and FND are also vastly different. Taken together, we emphasize that POTS and other common autonomic disorders are not FND and are not "functional" in etiology. Additionally, we believe that uniformly recommending FND-targeted exercise for patients who are misdiagnosed with FND or diagnosed with FND in conjunction with an autonomic disorder, is inappropriate and not in line with the current diagnostic criteria and scientific evidence.

https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1490744/abstract

 

I think the following echoes points made in Jonathan's recent Qeios paper.

 

I still haven't seen that actually supports the existence of any functional anything that isn't a simple "we don't know yet, and therefore assume there is nothing to know". It's every bit as bad as the evidence for the fictional behavioral model of chronic fatigue.

The illnesses are real, the models are just delusional fiction. Medicine will always have to deal with illnesses they can't fully understand. It's part of the job. It's part of most jobs, you have to learn to deal with it. That they still can't deal with this is absurd. The demons of old have been replaced with narratives.

 

I worry that this fuels the idea that 'exercises are fine for those other 'functional' people as long as they aren't used for our patients'. There is no evidence that exercises should be recommended for anyone, I suspect.