MedPage Today: Functional neurological disorder may still carry stigma

Functional neurological disorder (FND), disorders caused by an brain signaling abnormality with no significant structural brain damage, can lead to a variety of symptoms including sensory changes, weakness, involuntary movements, gait disturbances and speech problems.

FND primarily affects women, and researchers recently published a review arguing the disorder is often misunderstood and needs better recognition and parity in medical education, research and clinical service.

The University of Cincinnati's Alberto Espay, MD, was not involved in the review and provided comments to MedPage Today.

"The stigma attached to FND also comes from an era when FND was confused with malingering -- that is, the idea that patients were 'faking' their symptoms," said Espay, director and endowed chair of the James J. and Joan A. Gardner Family Center for Parkinson’s Disease and Movement Disorders at the UC Gardner Neuroscience Institute and a UC Health physician. 

"While this was entirely inaccurate, the effects have persisted." Espay continued. "As the authors point out, the evidence shows that FND is not compatible with feigning."

Espay said doctors need to be aware of the lingering prejudice surrounding the disorder and focus on making diagnoses entirely dependent on neurological exams, independent from psychological stressors.

"If it were not for the strong association of FND with sexual abuse, which disproportionally afflicts women, the prevalence of FND may be similar in men and women, quite different from what we have been led to believe," he added.

Read the MedPage Today article.

Featured photo at top of Dr. Espay. Photo/University of Cincinnati.

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