Paediatric Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
Arch Dis Child. 2019 Dec;104(12):1155-1160. doi: 10.1136/archdischild-2018-316519. Epub 2019 Jul 20.
To establish the incidence and long-term outcomes (up to 21 years) of children presenting to a University hospital paediatric neurology service with symptoms due to functional neurological disorder (FND) with particular reference to occurrence of FND or similar symptoms in adulthood.
Retrospective chart review to determine characteristics of the original paediatric FND presentation plus record-linkage with providers of Child and Adolescent Mental Health Services. Chart review of adult medical records for documentation of functional symptoms in adulthood.
124 individuals (56% female) met entry criteria. The most common presentations were seizures (18%), sensory loss (18%) and motor symptoms (16%). Frequency gradually increased with age of onset with an incidence in paediatric neurological services of 6 per 100 000 children under 16. In up to 21 years' follow-up (median 8.3 years), 114/124 attained their 16th birthdays by the study census date and were thus eligible for inclusion in an analysis of symptom persistence/recurrence in adulthood. 26/114 (23%) showed evidence of FND in adulthood of sufficient significance to be recorded in medical records.
Paediatric FND is commoner than previous estimates. Even in this selected population of children reaching specialist paediatric neurology services, a high long-term remission rate is observed.
调查因功能性神经障碍（FND）而出现症状并到大学医院儿科神经科就诊的儿童的发病率和长期结局（最长可达 21 年），尤其关注 FND 或类似症状在成年后的发生情况。
通过回顾性病历审查，确定儿童期 FND 首发的特征，并与儿童和青少年心理健康服务机构的提供者进行记录链接。对成年期的医疗记录进行病历审查，以记录成年期功能性症状。
共有 124 名符合入选标准的个体（56%为女性）。最常见的表现为癫痫发作（18%）、感觉缺失（18%）和运动症状（16%）。发病频率随发病年龄逐渐增加，16 岁以下儿童在儿科神经科就诊的发病率为每 10 万人中有 6 例。在最长 21 年的随访（中位数为 8.3 年）中，124 名中有 114 名（114/124，92%）在研究截止日期前达到 16 岁生日，因此有资格对成年后症状持续/复发进行分析。26/114（23%）在成年后出现了足够严重的 FND 证据，这些证据被记录在医疗记录中。
儿科 FND 比之前的估计更为常见。即使在这组到达儿科神经科专科的儿童中，也观察到了较高的长期缓解率。
