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April 2020; 10 (2) The Nerve! Readers Speak

Reader response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light

Nitin K. Sethi
First published April 6, 2020, DOI: https://doi.org/10.1212/CPJ.0000000000000820
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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.

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  • Author disclosures are available upon request (ncpjournal{at}neurology.org)

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References

  1. 1.↵
    1. Strom LA
    . Functional neurologic disorders: Bringing the informal and hidden curriculum to light. Neurol Clin Pract Epub 2019 Dec 19.

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