Functional neurological disorder in the emergency department

We provide a narrative review of functional neurological disorder (FND, or conversion disorder) for the emergency department (ED). Diagnosis of FND has shifted from a rule-out disorder to one now based on the recognition of positive clinical signs, allowing the ED physician to make a suspected or likely diagnosis of FND. PubMed, Google Scholar, academic books, and a hand search through review article references were used to conduct a literature review. We review clinical features and diagnostic pitfalls for the most common functional neurologic presentations to the ED, including functional limb weakness, functional (nonepileptic) seizures, and functional movement disorders. We provide practical advice for discussing FND as a possible diagnosis and suggestions for initial steps in workup and management plans.

Automated summary

This narrative review provides an overview of functional neurological disorder (FND) in the emergency department (ED), emphasizing the shift towards diagnosing FND based on positive clinical signs. The review covers common functional neurological presentations and offers practical advice for discussing FND diagnosis and initial workup and management plans.