Brain disorder leaves lasting legacy of disability

Prof Jon Stone (Centre for Clinical Brain Sciences) and colleagues have carried out a study, tracking more than 100 patients suffering from Functional Neurological Disorder, a hidden brain condition which causes limb weakness or paralysis. Doctors frequently describe the disorder as a "software", rather than "hardware" problem of the brain. Four out of five people with this condition experience lasting physical difficulties. 

In their initial studies 14 years ago, researchers found that FND suffered from stigma due to the fact that it cannot be seen on conventional brain scans, even though it is as common and disabling as other conditions. For the follow-up study, patients had to fill in questionnaires to assess their physical and psychiatric symptoms, quality of life, and perception of their illness. The answers from these questionnaires showed that levels of physical disability and distress remained high, even after 14 years. 

Doctors can sometimes be reluctnat to offer a diagnosis of FND for fear of making a mistake, but the team found that these mistakes are rare and should not prevent them from making a diagnosis using clinical signs. The study results will hopefully help doctors to provide realistic prognoses in future and encourage more work on treatment.

Prof Jon Stone says, "Thankfully with better research and treatment those attitudes are changing. This study shows the importance of neurologists staying involved with the long-term management of patients to guide treatment and detect additional neurological conditions, which can rarely occur years after the start of FND. It should also help clinicians provide a more realistic prognosis for patients with FND when it causes limb weakness and stresses the importance of active and targeted treatment which many of these patients didn’t have."