Functional Neurological Disorder
Functional Neurological Disorder
- one of most common neurological conditions
- frequently present as dissociative seizures or stroke like presentations
- nearly 10% of hyper-acute stroke unit admissions are said to be FND
- Ix does not reveal pathology
- examination rely on distraction testing techniques:
- Hoover's sign - hip extension in a patient with unilateral functional weakness is weak when tested directly, but briefly returns to normal when triggered by contralateral hip flexion
- ‘give way’ weakness - full power is generated for a second, but then disappears
- distractibility, demonstrating a discrepancy between volitional and non-volitional motor function
- recurrent episodes with normal imaging suggest functional weakness rather than stroke or other neurological disorders