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Subsets of functional neurological disorders include functional neurologic symptom disorder (FNsD) (conversion disorder), functional movement disorder, and functional seizures. The diagnosis is made based on positive signs and symptoms in the history and examination during consultation of a neurologist. [3]
In the context of a positive Hoover's sign, functional weakness (or "conversion disorder") is much more likely than malingering or factitious disorder. [3] Strong hip muscles can make the test difficult to interpret. [4] Efforts have been made to use the theory behind the sign to report a quantitative result. [5]
Functional weakness is weakness of an arm or leg without evidence of damage or a disease of the nervous system. Patients with functional weakness experience symptoms of limb weakness which can be disabling and frightening such as problems walking or a 'heaviness' down one side, dropping things or a feeling that a limb just doesn't feel normal or 'part of them'.
Conversion disorder is now partly contained under functional neurological symptom disorder (FNsD). In cases of conversion disorder, there is a psychological stressor. The diagnostic criteria for functional neurologic symptom disorder, as set out in DSM-5, are:
Somatic symptom disorder and bodily distress disorder have significant overlap with functional disorders and are often assigned if someone would benefit from psychological therapies addressing psychological or behavioural factors which contribute to the persistence of symptoms. However, people with symptoms partly explained by structural ...
The symptom or deficit is not better explained by another medical or mental disorder. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation. Additionally, the specific symptom type must be reported "with attacks or seizures". [15]
Romberg's test is not a test of cerebellar function, as it is commonly misconstrued. Patients with severe cerebellar ataxia will generally be unable to balance even with their eyes open; [ 6 ] therefore, the test cannot proceed beyond the first step and no patient with cerebellar ataxia can correctly be described as Romberg's positive.
Uhthoff's symptom at Whonamedit? ↑ in neurological symptoms with exercise or other increase in body temperature Unterberger test: Siegfried Unterberger: neurology, ENT: vestibular lesions: patient walks in place with eyes closed;direction of rotation indicates vestibular lesion on that side Virchow's node: Rudolf Virchow: internal medicine ...
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