I read with interest the editorial by Strom1 about functional neurologic disorders (FNDs). As a treating physician, I have struggled with the multiple diagnostic labels attached to these patients by physicians of different medical specialties during the course of their clinical disease presentation. A neurologist may assign a patient who presents with chronic fatigue the diagnostic labels of narcolepsy, idiopathic hypersomnia, or chronic Lyme disease. A rheumatologist may assign the label of collagen vascular disease, and a psychiatrist may diagnose depression. This diagnostic ambiguity is troublesome for patients and clinicians alike. I contend that even the term FND needs to be revisited. A patient should be broadly labeled as having a functional disorder and only after characterization sublabeled and referred to an appropriate specialty physician.
Footnotes
Author disclosures are available upon request (ncpjournal@neurology.org)
References
- 1.Strom LA. Functional neurologic disorders: Bringing the informal and hidden curriculum to light. Neurol Clin Pract Epub 2019 Dec 19. [DOI] [PMC free article] [PubMed] [Google Scholar]
