Garcin Béatrice, Roze Emmanuel, Daubigney Antoine, Carle-Toulemonde Guilhem, Degos Bertrand, Hingray Coraline
Service de neurologie, hôpital Avicenne, hôpitaux universitaires de Paris - Seine-Saint-Denis, Sorbonne Paris Nord, Assistance publique-Hôpitaux de Paris, 93000 Bobigny, France.
Inserm, CNRS, Institut du cerveau, Hôpital Salpêtrière, DMU Neurosciences, Sorbonne université, Assistance publique-Hôpitaux de Paris, 75013 Paris, France.
Encephale. 2023 Aug;49(4S):S3-S8. doi: 10.1016/j.encep.2023.06.001. Epub 2023 Jul 1.
Functional neurological disorders (FND) are symptoms that can affect a variety of functions including motor, sensory and cognitive. These symptoms are genuinely experienced by the patient and are related to a functional disorder rather than a structural one. There is little epidemiological data on these disorders, but their frequency is well established in clinical practice, it is the second most frequent reason for consultation in Neurology. Despite of the frequency of the disorder, general practitioners and specialists are insufficiently trained in the disease, and patients often suffer from stigmatization and/or unnecessary investigations. It is therefore important to be aware of the diagnostic approach to FND, which mostly relies on positive clinical signs. Psychiatric evaluation can help with the characterization of predisposing, precipitating and perpetuating factors of the symptoms (according to the 3P biopsychosocial model related to FND), and guide their management. Finally, diagnosis explanation is a crucial step in the management of the disease, which can in itself have a therapeutic effect, and allow the patient to adhere to the treatments.
功能性神经障碍（FND）是一种症状，可影响包括运动、感觉和认知在内的多种功能。这些症状是患者切实体验到的，并且与功能性障碍而非结构性障碍有关。关于这些障碍的流行病学数据很少，但在临床实践中其发病率已得到充分证实，它是神经病学门诊的第二大常见原因。尽管该疾病发病率较高，但全科医生和专科医生对其的培训不足，患者经常遭受污名化和/或不必要的检查。因此，了解FND的诊断方法很重要，其主要依赖于阳性临床体征。精神科评估有助于根据与FND相关的3P生物心理社会模型对症状的诱发、促发和持续因素进行特征描述，并指导对这些症状的管理。最后，诊断解释是疾病管理中的关键一步，其本身可能具有治疗效果，并能使患者坚持治疗。
