Department of Clinical Neurosciences, Royal Hospital for Children and Young People, Edinburgh, UK.
Child Life and Health, MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK.
Dev Med Child Neurol. 2023 Sep;65(9):1238-1246. doi: 10.1111/dmcn.15538. Epub 2023 Feb 8.
To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children.
Children diagnosed with FND at a regional children's hospital were prospectively recruited by weekly active surveillance for 36 months. Demographic, clinical, and follow-up data were retrospectively extracted by review of electronic records. Descriptive statistical analyses were used.
Ninety-seven children (age range 5-15 years) met the case definition of FND (annual incidence 18.3 per 100 000 children). Children with FND were likely to be female (n = 68 [70%]) and older (median 13 years) with no difference in the Scottish Index of Multiple Deprivation (marker of socioeconomic status) compared with the general childhood population. Functional motor (41%) and sensory (41%) symptoms were most common; other somatic symptoms such as headache (31%) and pain (27%) were frequent. Self-reported psychiatric symptoms and infection/inflammation were the most common predisposing and precipitating factors respectively. At a median of 15 months follow-up, 49% of 75 children reported improvement or resolution of FND symptoms with no prognostic factors found.
At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.
报告儿童功能性神经障碍(FND)的发病率、人口统计学和临床特征以及症状转归。
通过每周主动监测,在一家区域儿童医院前瞻性招募 36 个月内诊断为 FND 的儿童。通过回顾电子病历提取人口统计学、临床和随访数据。采用描述性统计分析。
97 名儿童(年龄 5-15 岁)符合 FND 的病例定义(儿童发病率为 18.3/10 万)。FND 患儿更可能为女性(n=68[70%])和年龄较大(中位数 13 岁),与一般儿童人群相比,苏格兰多维贫困指数(社会经济地位的标志物)没有差异。功能性运动(41%)和感觉(41%)症状最为常见;其他躯体症状如头痛(31%)和疼痛(27%)也很常见。自我报告的精神症状和感染/炎症分别是最常见的诱发和促成因素。在中位数为 15 个月的随访中,75 名儿童中有 49%报告 FND 症状改善或缓解,但未发现预后因素。
在这个区域中心,儿童 FND 的发病率高于先前的报告,且结局不如其他一些研究乐观。