The prognosis of functional limb weakness: a 14-year case-control study

“As duration of symptoms has been found to be a negative prognostic factor (Gelauff et al., 2014), prognosis may be better in patients presenting to primary care or emergency settings.”

“Rates of diagnostic revision have been 4% since 1970 (Stone et al., 2005).”

“Not all diagnostic revision represents a ‘misdiagnosis’ and we categorized patients according to the classification of Stone et al. (2009).”

“The two studies that have investigated this have found no correlation between somatoform disorders and outcome (Crimlisk et al., 1998; Ibrahim et al., 2009).”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“functional motor symptoms the limited available data do not provide a meaningful answer (Crimlisk et al., 1998; Deuschl et al., 1998; Feinstein et al., 2001; Stone et al., 2003).”

“Most of these factors were based on standardized questionnaires (Stone et al., 2010).”

“Our own large epidemiological study of patients presenting to neurologists with symptoms lacking a pathophysiological explanation, a wider phenotype than functional motor symptoms (Carson et al., 2011), found a much lower frequency of that diagnostic revision and highlighted that actual diagnostic error was rare (4 ou…”

“functional motor symptoms the limited available data do not provide a meaningful answer (Crimlisk et al., 1998; Deuschl et al., 1998; Feinstein et al., 2001; Stone et al., 2003).”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“It is also the longest follow-up study ever for any functional neurological disorder (Gelauff and Stone, 2016).”

“This is in line with observations that functional neurological disorders often occur in the context of recognized neurological disease (Stone et al., 2012a; Pareés et al., 2013; Wissel et al., 2018).”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“Other smaller studies of outcome of patients with functional weakness, with 10–30 patients over 0.5–6 years, found a large range of outcomes with 10–56% being the same or worse weakness at follow-up (Carter, 1949; Brown and Pisetsky, 1954; Knutsson and Mårtensson, 1985; Binzer and Kullgren, 1998).”

“Other studies of patients with functional motor disorders have found a low frequency of being in work ranging from 11% to 57% (Binzer and Kullgren, 1998; Crimlisk et al., 1998).”

“The two studies that have investigated this have found no correlation between somatoform disorders and outcome (Crimlisk et al., 1998; Ibrahim et al., 2009).”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“This is in line with observations that functional neurological disorders often occur in the context of recognized neurological disease (Stone et al., 2012a; Pareés et al., 2013; Wissel et al., 2018).”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“…have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001;…”

“Factors that have most consistently correlated with positive outcome in the literature included an early diagnosis and short duration of symptoms at baseline (Knutsson and Mårtensson, 1985; Couprie et al., 1995; Factor et al., 1995; Mace and Trimble, 1996; Crimlisk et al., 1998; Feinstein et al., 2001; Thomas et al.,…”

“Four studies have been published on the baseline data (Stone et al., 2010, 2012b; Ludwig et al., 2015; Whitehead et al., 2015).”

“Duncan et al. (2014) found a death rate of 0.58% per year in a group of patients with psychogenic non-epileptic attacks (n = 260).”

“Four studies have been published on the baseline data (Stone et al., 2010, 2012b; Ludwig et al., 2015; Whitehead et al., 2015).”

“5–6 years, found a large range of outcomes with 10–56% being the same or worse weakness at follow-up (Carter, 1949; Brown and Pisetsky, 1954; Knutsson and Mårtensson, 1985; Binzer and Kullgren, 1998).”

“117 118 Recently, efforts have been made to integrate additional clinical features in the process of diagnosis, such as, for example, abrupt onset, fluctuations of the motor symptom, comorbid pain, and fatigue.”

“2nd most common outpatient neurologic diagnosis, with many patients remaining chronically symptomatic and incurring high healthcare costs (Gelauff et al., 2019; Stephen et al., 2021; Stone et al., 2010a).”

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