title: Functional neurological disorders in outpatient practice: An Australian cohort.
abstract: Functional disorders are defined as neurological symptoms without causative organic pathology identified. They are a diverse and often neglected group of disorders. The aim of this was to determine the incidence and outcome of functional neurological disorders in an Australian neurology practice. Over a 17month period, all patients presenting to a single outpatient neurology service were evaluated to determine the incidence and outcome of these disorders. A total of 884 patients were assessed and of these, 137 had a final diagnosis of functional neurological illness, equating to an incidence of 15% of all patients seen. Functional disorders were the third most common presentation overall. Patients with functional disorders were younger, more likely to be female and had a higher rate of current psychiatric comorbidity compared to other neurology patients. Sensory symptoms were the most common manifestation (48%) followed by limb weakness (37%) and psychogenic non-epileptic seizures (14%). Outcome information was available for 49% of patients at an average of 3months follow-up. 45% had some improvement in their symptoms, 43% had static symptoms and 12% had worsening of symptoms. This study confirms the high incidence of functional disorders in outpatient neurology practice. Early improvement was seen in a substantial proportion of patients and is influenced by duration of symptoms.
authors.affiliation: Department of Neurology, Macquarie University Hospital, 2 Technology Place, Macquarie University, Sydney, NSW 2109, Australia. Electronic address: o_ahmad21@hotmail.com.
authors.forename: Omar
authors.initials: O
authors.lastname: Ahmad
authors.affiliation: Department of Neurology, Royal North Shore Hospital, NSW, Australia.
authors.forename: Kate E
authors.initials: KE
authors.lastname: Ahmad
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003291:Conversion Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D000071896:Medically Unexplained Symptoms; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D010045:Outpatients / Q000706:statistics & numerical data; D013001:Somatoform Disorders / Q000453:epidemiology*; D055815:Young Adult
keywords: Conversion disorder; Functional disorders; Medically unexplained symptoms; Psychiatry