The clinical management of functional neurological disorder: A scoping review of the literature

Neurological Dysfunction in Long COVID Should Not Be Labelled as Functional Neurological Disorder

“…There have been suggestions that Long COVID may be purely functional (i.e., psychological) in origin [ 54 ] and it is possible that ’diagnosing’ patients with Long COVID with FND is symptomatic of that line of thought. However, although FND, if properly diagnosed, is likely a valid clinical disorder, it is often over-diagnosed without paying attention to rule-in symptoms, especially in vulnerable and underserved populations [ 21 ]. And although a study found that people with pre-infection anxiety or depression had increased risk of self-reported post-COVID-19 conditions [ 55 ], this is a phenomenon that can occur in medical conditions more generally, also conditions that are not considered to be functional in nature.…”

“…FND has been the subject of academic and clinical debate for centuries, with limited understanding of the underlying mechanism, diagnostic methods and effectiveness of treatment [ 21 ]. Although the diagnosis is dependent predominantly on the exclusion of any other medical condition that could account for the symptoms according to the ICD-11 and DSM-5-TR, current neurological practice of FND classification allows for such comorbidity, for example in case of motor symptoms in Long COVID patients.…”

Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position

“…Indeed, clinicians and commentators who publicly champion the agnostic approach continue to: emphasize the need for psychiatric assessment for all patients; 10 recommend psychotherapies (e.g., cognitive behavioural therapy (CBT)) for most patients; and when medications are prescribed, they are invariably psychotropics. 27 This is confusing, even disingenuous. Patients notice the apparent contradictions.…”

BOLD signal variability as potential new biomarker of functional neurological disorders

“…Functional neurological disorder (FND) is a common medical condition ( Bennett et al, 2021 , Carson and Lehn, 2016 ; Hallett et al, n.d.) presenting with diverse neurological symptoms and typically motor or sensory symptom patterns that cannot been explained by an underlying classical neurological disorder ( Aybek and Perez, 2022 , Espay et al, 2018a ). Currently there are well established rule-in diagnostic criteria (Association and Force, 2013; Varley et al, 2023 ) and multimodal treatment options available ( Bennett et al, 2021 ; Hallett et al, n.d.; LaFaver, 2020 , Varley et al, 2023 ), but our understanding of the neuropathophysiological mechanisms, the underlying development and clinical course of the diverse symptoms remains limited ( Drane et al, 2021 ).…”