Functional symptoms and signs in neurology: Assessment and diagnosis

Neurology in Practice

Volumn 76, Issue 1, 2005, Pages

  Stone, Jon ^a,b   Carson, A ^b   Sharpe, M ^b  

^a WESTERN GENERAL HOSPITAL   (United Kingdom)

^b UNIVERSITY OF EDINBURGH   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

PROLACTIN;

ANAMNESIS; CLINICAL FEATURE; DIAGNOSTIC APPROACH ROUTE; DISSOCIATION; DIZZINESS; DYSPHAGIA; DYSTONIA; ELECTROENCEPHALOGRAM; EMOTION; FUNCTIONAL ASSESSMENT; FUNCTIONAL DISEASE; GAIT DISORDER; HEARING DISORDER; HUMAN; HYPNOSIS; MOTOR DYSFUNCTION; MUSCLE WEAKNESS; NEUROLOGIC DISEASE; NEUROLOGIC EXAMINATION; NEUROLOGY; PRIORITY JOURNAL; PROLACTIN BLOOD LEVEL; REVIEW; SEDATION; SENSORY DYSFUNCTION; SPEECH DISORDER; SYMPTOM; TELEMETRY; TREMOR; VISUAL DISORDER;

ATTITUDE TO HEALTH; DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC TECHNIQUES, NEUROLOGICAL; DISSOCIATIVE DISORDERS; FACTITIOUS DISORDERS; FEMALE; FUNCTIONAL LATERALITY; HEALTH STATUS; HUMANS; MALE; MEDICAL HISTORY TAKING; MOVEMENT DISORDERS; NERVOUS SYSTEM DISEASES; NEUROLOGIC EXAMINATION; NEUROLOGY; PSYCHOPHYSIOLOGIC DISORDERS; SEIZURES; SOMATOFORM DISORDERS; TERMINOLOGY;

EID: 14344261292     PISSN: 14737086     EISSN: None     Source Type: Journal    
DOI: 10.1136/jnnp.2004.061655     Document Type: Review

References (19)

1. Carson AJ, Ringbauer B, Stone J, et al. Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry 2000;68:207-10. Providing that "one third" figure and showing that disability and distress are comparable to patients with disease.
2. Wessely S, Nimnuan C, Sharpe M. Functional somatic syndromes: one or many? Lancet 1999;354:936-9. A review article examining the similarities between symptom syndromes in different medical specialities.
3. Reuber M, Elger CE. Psychogenic nonepileptic seizures: a review and update. Epilepsy and Behaviour 2003;4:205-16. A thorough recent review of the exponentially increasing literature an non-epileptic attacks.
4. Thomas M, Jankovic J. Psychogenic movement disorders: diagnosis and management. CNS Drugs 2004;18:437-52. A summary of the literature an functional movement disorders.
5. Stone J, Zeman A, Sharpe M. Functional weakness and sensory disturbance. J Neurol Neurosurg Psychiatry 2002;73:241-5. A review of physical signs of functional weakness and sensory disturbance.
6. Ziv I, Djaldetti R, Zoldan Y, et al. Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: the quantitative Hoover's test. J Neurol 1998;245:797-802. A neurophysiological study supporting the validity of Hoover's sign. Proof that science is possible in this area.
7. Gould R, Miller BL, Goldberg MA, et al. The validity of hysterical signs and symptoms. J Nerv Ment Dis 1986;174:593-7. An often quoted study showing that so called "hysterical signs" such as "la belle indifférence", collapsing weakness and midline splitting were often found in patients presenting with acute stroke.
8. Vuilleumier P, Chicherio C, Assal F, et al. Functional neuroanatomical correlates of hysterical sensorimotor loss. Brain 2001;124:1077-90. The mast convincing functional imaging study of patients with functional motor and sensory symptoms.
9. McGonigal A, Oto M, Russell AJ, et al. Outpatient video EEG recording in the diagnosis of non-epileptic seizures: a randomised controlled trial of simple suggestion techniques. J Neurol Neurosurg Psychiatry 2002;72:549-51. Describing a method of inducing non-epileptic attacks during videotelemetry using simple suggestion rather than deceptive placebo.
10. Sawle G, Brown P. Movement disorders in clinical practice. Oxford: Isis Medical Media, 1999. Contains a CD Ram with several videos of patients with functional movement disorders including a demonstration of tremor entrapment.
11. Schrag A, Trimble M, Quinn N, et al. The syndrome of fixed dystonia: an evaluation of 103 patients. Brain 2004;127:2360-72. A clinical exploration of patients with permanently clenched fists, inverted feet and the like.
12. Lempert T, Brandt T, Dieterich M, et al. How to identify psychogenic disorders of stance and gait. A video study in 37 patients. J Neurol 1991;238:140-6. A practical and detailed review of functional gait disorder with plenty of photos.
13. Hayes MW, Graham S, Heldorf P, et al. A video review of the diagnosis of psychogenic gait: appendix and commentary. Mov Disord 1999;14:914-21. A very helpful "video article" of 22 gaits, half of whom have functional gaits. Great teaching material as it also includes "standard" gait abnormalities.
14. Furman JM, Jacob RG. Psychiatric dizziness. Neurology 1997;48:1161-6. A thoughtful review of the role of psychological factors in dizziness.
15. Roy N. Functional dysphonia. Curr Opin Otolaryngol Head Neck Surg 2003;11:144-8. An review of functional dysphonia.
16. Beatty S. Non-organic visual loss. Postgrad Med J 1999;75:201-7. An review of clinical signs used in the detection of functional visual symptoms.
17. Stone J. Pseudoptosis. Practical Neurology 2002;2:364-5.
18. Charcot JM. Clinical lectures on diseases of the nervous system. London: New Sydenham Society, 1889.
19. Purves-Stewart J, Worster-Drought C. The psychoneuroses and psychoses. In: Diagnosis of nervous diseases. Baltimore: The Williams and Wilkins Company, 1952:661-758.