Neurology, 6429Stanford University, Palo Alto, CA, USA.
School of Nursing, 7149University of San Francisco, San Francisco, CA, USA.
J Child Neurol. 2022 Aug;37(8-9):669-676. doi: 10.1177/08830738221113899. Epub 2022 Jul 11.
This is a multicenter retrospective EMR-based chart review of 88 patients aged 3-21 years admitted for evaluation of functional neurologic disorder (FND). We sought to establish characteristics associated with FND, calculate incidence of abnormal neurodiagnostic findings, and determine features associated with variability in workup and treatment. FND patients were 65% female, 40% White, 33% Hispanic, and 88% primarily English speaking with median 13.9 years. We detected variability in management by age, ethnicity, psychiatric comorbidity, and hospital site. Our findings suggest limited utility to CTs in this setting (100% normal) and that workup can be safely informed by physical exam, which predicted abnormal MRI and LP results. We favor screening for adverse childhood experiences in FND patients. Hospitalization may be a rare opportunity for psychiatry contact.
这是一项基于电子病历的多中心回顾性图表研究，共纳入 88 名年龄在 3-21 岁之间的功能性神经障碍（FND）患者。我们旨在确定与 FND 相关的特征，计算异常神经诊断结果的发生率，并确定与检查和治疗变异性相关的特征。FND 患者中女性占 65%，白人占 40%，西班牙裔占 33%，88%的患者主要讲英语，中位数为 13.9 岁。我们发现，管理方式因年龄、种族、精神共病和医院地点而异。我们的研究结果表明，在这种情况下 CT 的作用有限（100%正常），并且体格检查可以安全地指导检查，预测 MRI 和 LP 结果异常。我们赞成在 FND 患者中筛查不良童年经历。住院可能是精神病学接触的罕见机会。
