Reader response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light
Nitin K.Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY U.S.A.
Submitted January 02, 2020
I read with interest the editorial by Strom about functional neurologic disorders (FND). [1] 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 (FD) and only after characterization sub-labeled and referred to an appropriate specialty physician.
1. Strom LA. Functional neurologic disorders: Bringing the informal and hidden curriculum to light. Neurol Clin Pract Dec 2019, 10.1212/CPJ.0000000000000797; DOI: 10.1212/CPJ.0000000000000797
I read with interest the editorial by Strom about functional neurologic disorders (FND). [1] 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 (FD) and only after characterization sub-labeled and referred to an appropriate specialty physician.
1. Strom LA. Functional neurologic disorders: Bringing the informal and hidden curriculum to light. Neurol Clin Pract Dec 2019, 10.1212/CPJ.0000000000000797; DOI: 10.1212/CPJ.0000000000000797
For disclosures, please contact the editorial office at ncpjournal@neurology.org.