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Functional neurological disorders: the neurological assessment as treatment
Open accessAbstract
The neurologist's role in patients with functional disorders has traditionally been limited to making the diagnosis, excluding a ‘disease’ and pronouncing the symptoms to be ‘non-organic’ or ‘psychogenic’. In this article, I argue that there are multiple opportunities during routine assessment of a patient with a functional disorder for the neurologist to take the lead with treatment. These opportunities occur throughout history taking, during the examination and, with greatest potential for treatment, at the end of the consultation. Elements of the neurologist's discussion that may be most useful include (a) emphasis that symptoms are genuine, common and potentially reversible; (b) explanation of the positive nature of the diagnosis (ie, not a diagnosis of exclusion); (c) simple advice about distraction techniques, self-help techniques and sources of information; (d) referral on to appropriate physiotherapy and/or psychological services; and (e) offering outpatient review. I also discuss how new diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders-5 and changes proposed for International Classification of Diseases may facilitate changes that allow neurologists to bring their management of patients with functional disorders in line with other multidisciplinary neurological disorders in the outpatient clinic.
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“symptoms amplify with attention, and they diminish when attention is drawn away from them (and toward something else) [19,51,53].”
From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [53]
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“symptoms amplify with attention, and they diminish when attention is drawn away from them (and toward something else) [19,51,53].”
From Illness-Promoting Psychological Processes in Children and Adolescents with Functional Neurological Disorder (2023) · cites this paper as [53]
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Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
The functional gastrointestinal disorders and the Rome III process
Drossman, D. A. (2006) · Gastroenterology · doi:10.1053/j.gastro.2006.03.008 · Cited by 2,416
A Bayesian account of ‘hysteria’
Edwards, M. J., Adams, R. A., Brown, H., Parees, I., & Friston, K. J. (2012) · Brain · doi:10.1093/brain/aws129 · Cited by 825
Medically unexplained symptoms
Nimnuan, C., Hotopf, M., & Wessely, S. (2001) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(01)00223-9 · Cited by 622
Who is referred to neurology clinics?—The diagnoses made in 3781 new patients
Stone, J., Carson, A. J., Duncan, R., Roberts, R., Warlow, C., Hibberd, C., Coleman, R. J., Cull, R. E., Murray, G. D., Pelosi, A. J., et al. (2010) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2010.05.011 · Cited by 538
Self-citationCognitive-behavioral therapy for psychogenic nonepileptic seizures
Goldstein, L. H., Chalder, T., Chigwedere, C., Khondoker, M. R., Moriarty, J., Toone, B., & Mellers, J. D. C. (2010) · Neurology · doi:10.1212/wnl.0b013e3181e39658 · Cited by 499
Physiotherapy for functional motor disorders: a consensus recommendation
Nielsen, G., Stone, J., Matthews, A., Brown, M., Sparkes, C., Farmer, R., Masterton, L., Duncan, L., Winters, A., Daniell, L., et al. (2014) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2014-309255 · Cited by 427
Self-citationThe prognosis of functional (psychogenic) motor symptoms: a systematic review
Gelauff, J., Stone, J., Edwards, M., & Carson, A. (2014) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2013-305321 · Cited by 368
Self-citationThe syndrome of fixed dystonia: an evaluation of 103 patients
Schrag, A. E., Trimble, M., Quinn, N. P., & Bhatia, K. P. (2004) · Brain · doi:10.1093/brain/awh262 · Cited by 351
Functional (psychogenic) movement disorders: merging mind and brain
Edwards, M. J., & Bhatia, K. P. (2012) · The Lancet Neurology · doi:10.1016/s1474-4422(11)70310-6 · Cited by 314
Avberšek, A., & Sisodiya, S. M. (2010) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2009.197996 · Cited by 243
Guided self-help for functional (psychogenic) symptoms
Sharpe, M., Walker, J., Williams, C. M., Stone, J., Cavanagh, J., Murray, G. D., Butcher, I., Duncan, R., Smith, S., & Carson, A. J. (2011) · Neurology · doi:10.1212/wnl.0b013e318228c0c7 · Cited by 213
Self-citationJordbru, A., Smedstad, L. M., Klungsøyr, O., & Martinsen, E. W. (2014) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-1246 · Cited by 208
Psychopathology and psychogenic movement disorders
Kranick, S. M., Ekanayake, V., Martinez, V., Ameli, R., Hallett, M., & Voon, V. (2011) · Movement Disorders · doi:10.1002/mds.23830 · Cited by 207
Is there a better term than “medically unexplained symptoms”?
Creed, F., Guthrie, E., Fink, P., Henningsen, P., Rief, W., Sharpe, M., & White, P. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2009.09.004 · Cited by 207
Stone, J., & Edwards, M. J. (2012) · Neurology · doi:10.1212/wnl.0b013e31825fdf63 · Cited by 200
Self-citationPhysical precipitating factors in functional movement disorders
Pareés, I., Kojovic, M., Pires, C., Rubio-Agusti, I., Saifee, T. A., Sadnicka, A., Kassavetis, P., Macerollo, A., Bhatia, K. P., Carson, A., et al. (2014) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2013.12.046 · Cited by 189
Self-citationDaum, C., Hubschmid, M., & Aybek, S. (2013) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-304607 · Cited by 187
Conversion Disorder: Current problems and potential solutions for DSM-5
Stone, J., LaFrance, W. C., Jr., Brown, R. J., Spiegel, D., Levenson, J. L., & Sharpe, M. (2011) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.07.005 · Cited by 181
Self-citationFunctional symptoms in neurology
Stone, J. (2009) · Practical Neurology · doi:10.1136/jnnp.2009.177204 · Cited by 177
Self-citationFrom psychogenic movement disorder to functional movement disorder: It's time to change the name
Edwards, M. J., Stone, J., & Lang, A. E. (2013) · Movement Disorders · doi:10.1002/mds.25562 · Cited by 160
Self-citationFunctional (conversion) neurological symptoms: research since the millennium
Carson, A. J., Brown, R. J., David, A. S., Duncan, R., Edwards, M. J., Goldstein, L. H., Grünewald, R. A., Howlett, S., Kanaan, R., Mellers, J. D. C., et al. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2011-301860 · Cited by 145
Self-citationPhysiotherapy for functional (psychogenic) motor symptoms: A systematic review
Nielsen, G., Stone, J., & Edwards, M. J. (2013) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2013.05.006 · Cited by 143
Self-citationOutcomes of a 5-day physiotherapy programme for functional (psychogenic) motor disorders
Nielsen, G., Ricciardi, L., Demartini, B., Hunter, R. M., Joyce, E. M., & Edwards, M. J. (2015) · Journal of Neurology · doi:10.1007/s00415-014-7631-1 · Cited by 135
Multidisciplinary treatment for functional neurological symptoms: a prospective study
Demartini, B., Batla, A., Petrochilos, P., Fisher, L., Edwards, M. J., & Joyce, E. M. (2014) · Journal of Neurology · doi:10.1007/s00415-014-7495-4 · Cited by 130
In the psychiatrist's chair: how neurologists understand conversion disorder
Kanaan, R., Armstrong, D., Barnes, P., & Wessely, S. C. (2009) · Brain · doi:10.1093/brain/awp060 · Cited by 126
Accelerometry to distinguish psychogenic from essential or parkinsonian tremor
Zeuner, K. E., Shoge, R. O., Goldstein, S. R., Dambrosia, J. M., & Hallett, M. (2003) · Neurology · doi:10.1212/01.wnl.0000076183.34915.cd · Cited by 126
Reproductive dysfunction in women with epilepsy: recommendations for evaluation and management
Bauer, J. (2002) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.73.2.121 · Cited by 119
Sharpe, M., Stone, J., Hibberd, C., Warlow, C., Duncan, R., Coleman, R. J., Roberts, R., Cull, R. E., Pelosi, A. J., Cavanagh, J., et al. (2009) · Psychological Medicine · doi:10.1017/s0033291709990717 · Cited by 117
Self-citationMcCormack, R., Moriarty, J., Mellers, J. D. C., Shotbolt, P., Pastena, R., Landes, N., Goldstein, L. H., Fleminger, S., & David, A. S. (2013) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2013-305716 · Cited by 114
Psychogenic facial movement disorders: Clinical features and associated conditions
Fasano, A. A., Valadas, A., Bhatia, K. P., Kukkle, P. L., Lang, A. E., Munhoz, R. P., Morgante, F., Tarsy, D., Duker, A. P., Girlanda, P., et al. (2012) · Movement Disorders · doi:10.1002/mds.25190 · Cited by 113
Stone, J., Carson, A., Duncan, R., Roberts, R., Coleman, R., Warlow, C., Murray, G., Pelosi, A., Cavanagh, J., Matthews, K., et al. (2012) · Journal of Neurology · doi:10.1007/s00415-011-6111-0 · Cited by 110
Self-citationDifferential diagnosis of seizure disorders: A conversation analytic approach
Schwabe, M., Howell, S. J., & Reuber, M. (2007) · Social Science & Medicine · doi:10.1016/j.socscimed.2007.03.045 · Cited by 106
Functional weakness: Clues to mechanism from the nature of onset
Stone, J., Warlow, C., & Sharpe, M. (2012) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp-2011-300125 · Cited by 106
Self-citationPsychogenic nonepileptic seizure manifestations reported by patients and witnesses
Reuber, M., Jamnadas-Khoda, J., Broadhurst, M., Grünewald, R. A., Howell, S., Koepp, M. J., Sisodiya, S. M., & Walker, M. C. (2011) · Epilepsia · doi:10.1111/j.1528-1167.2011.03162.x · Cited by 105
Cohort study on somatoform disorders in Parkinson disease and dementia with Lewy bodies
ONOFRJ, M. C., Bonanni, L., Manzoli, L., & Thomas, A. (2010) · Neurology · doi:10.1212/wnl.0b013e3181df09dd · Cited by 105
Patients whom neurologists find difficult to help
Carson, A. J. (2004) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.2003.032169 · Cited by 105
McWhirter, L., Stone, J., Sandercock, P. A., & Whiteley, W. N. (2011) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.09.003 · Cited by 99
Self-citationThe ‘disappearance’ of hysteria: Historical mystery or illusion?
Stone, J., Hewett, R. M., Carson, A. J., Warlow, C. P., & Sharpe, M. (2008) · Journal of the Royal Society of Medicine · doi:10.1258/jrsm.2007.070129 · Cited by 89
Self-citationInpatient treatment of functional motor symptoms: a long-term follow-up study
Saifee, T. A., Kassavetis, P., Pareés, I., Kojović, M., Fisher, L., Morton, L. B., Foong, J., Price, G. W., Joyce, E. M., & Edwards, M. J. (2012) · Journal of Neurology · doi:10.1007/s00415-012-6530-6 · Cited by 85
Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb.
Sonoo, M. (2004) · PubMed · Cited by 83
Functional symptoms in neurology: mimics and chameleons
Stone, J., Reuber, M., & Carson, A. (2013) · Practical Neurology · doi:10.1136/practneurol-2012-000422 · Cited by 72
Self-citationFunctional (psychogenic) symptoms in Parkinson's disease
Pareés, I., Saifee, T. A., Kojović, M., Kassavetis, P., Rubio‐Agusti, I., Sadnicka, A., Bhatia, K. P., & Edwards, M. J. (2013) · Movement Disorders · doi:10.1002/mds.25544 · Cited by 69
Hubschmid, M., Aybek, S., Maccaferri, G. E., Chocron, O., Gholam‐Rezaee, M., Rossetti, A. O., Vingerhoets, F., & Berney, A. (2015) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2015.05.007 · Cited by 67
Functional neurological disorders: The neurological assessment as treatment
Stone, J. (2014) · Neurophysiologie Clinique · doi:10.1016/j.neucli.2014.01.002 · Cited by 63
Self-citationStone, J., & Carson, A. (2013) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2012-304842 · Cited by 62
Self-citationPractical clinical approaches to functional visual loss
Chen, C. S., Lee, A. W., Karagiannis, A., Crompton, J. L., & Selva, D. N. (2006) · Journal of Clinical Neuroscience · doi:10.1016/j.jocn.2006.03.002 · Cited by 57
Functional disorders in the Neurology section of ICD-11
Stone, J., Hallett, M., Carson, A. J., Bergen, D. C., & Shakir, R. A. (2014) · Neurology · doi:10.1212/wnl.0000000000001063 · Cited by 57
Self-citationEdwards, M. J., Stone, J., & Nielsen, G. (2012) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp-2011-302147 · Cited by 56
Self-citationMigraine with unilateral motor symptoms: a case-control study
Young, W., Gangal, K. S., Aponte, R. J., & Kaiser, R. S. (2006) · Journal of Neurology Neurosurgery & Psychiatry · doi:10.1136/jnnp.2006.100214 · Cited by 48
“Psychogenic Movement Disorders”: They Are What They Are
Fahn, S., & Olanow, C. W. (2014) · Movement Disorders · doi:10.1002/mds.25899 · Cited by 43
Price, J. R. (2000) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(99)00070-7 · Cited by 32
Attention and postural control in patients with conversion paresis
Stins, J. F., Kempe, C., Hagenaars, M. A., Beek, P. J., & Roelofs, K. (2014) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2014.11.009 · Cited by 26
Dissociation: what is it and why is it important?
Stone, J. (2006) · Practical Neurology · doi:10.1136/jnnp.2006.101287 · Cited by 18
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Metadata
- Authors
- Stone, J.
- Affiliations
- Western General Hospital (GB)
- Corresponding author
- Stone, Jon
- ORCID
- Stone, Jon
- Venue
- Practical Neurology
- Publisher
- BMJ
- Published
- 2015-12-29
- Volume
- 16
- Issue
- 1
- Pages
- 7-17
- ISSN
- 1474-7758 (ISSN-L)
- 1474-7766
- OpenAlex
- W2230375827
- Cited by
- 157
- References
- 54
- Citations by year
- 2026: 17 · 2025: 14 · 2024: 9 · 2023: 21 · 2022: 19 · 2021: 23 · 2020: 15 · 2019: 13 · 2018: 7 · 2017: 12 · 2016: 7
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Practical Neurology (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- NHS Health Scotland
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- conversion disorder, neurological assessment, diagnosis of exclusion, patient education, distraction techniques, self-help, referral to physiotherapy, DSM-5 diagnostic criteria, multidisciplinary management
- MeSH terms
- Humans, Nervous System Diseases, Neurologic Examination
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