Landa Jana, Silberg Tamar, Gerner Maya, Eisenstein Etzyona, Barak Sharon
The Edmond and Lily Safra Children's Hospital, Department of Pediatric Rehabilitation, The Chaim Sheba Medical Center, The Sackler Faculty of Medicine, Tel Aviv University.
The Edmond and Lily Safra Children's Hospital, Department of Pediatric Rehabilitation, The Chaim Sheba Medical Center, School of Health Sciences, Department of Nursing, Ariel University.
Harefuah. 2024 Sep;163(9):571-578.
Functional neurological disorder (FND) and complex regional pain syndrome (CRPS) are disorders that affect quality of life. CRPS diagnosis is based on Budapest criteria that include various signs/symptoms. Despite the similarity in the etiology/pathophysiology of FND and CRPS, the joint prevalence of these two conditions in youth has not yet been reported. Given that both phenomena are less familiar among pediatric patients, it is crucial to thoroughly characterize them and establish a clear differential diagnosis. This, in turn, holds significant implications for guiding therapeutic interventions.
We aimed to examine: 1) the clinical profile of children with FND; 2) the prevalence of CRPS among children with FND; and 3) differences in clinical characteristics and in Budapest's symptoms/signs between children with FND and those with a co-diagnosis of FND and CRPS.
Sixty-one children (mean age: 13.70+2.93 years; 75.4% females) diagnosed with FND were studied. Sample's demographic, clinical characteristics and the Budapest CRPS classification criteria were collected from medical files.
Most children with FND reported sensory (67%) and motor (88%) symptoms. Forty-four percent had a co-diagnosis of FND and CRPS. Among these children, 100% reported sensory and motor/tropical, 74% vasomotor, and 65% sudomotor symptoms. The prevalence of Budapest symptoms, except for motor-function impairment, was significantly higher among children with a co-diagnosis compared to children with FND alone.
The high frequency of symptoms and clinical signs in children with co-incidence of CRPS and FND may indicate a shared developmental mechanism and is important for the development of appropriate rehabilitation interventions.
功能性神经障碍（FND）和复杂性区域疼痛综合征（CRPS）是影响生活质量的疾病。CRPS的诊断基于包括各种体征/症状的布达佩斯标准。尽管FND和CRPS在病因/病理生理学上有相似之处，但这两种疾病在青少年中的联合患病率尚未见报道。鉴于这两种现象在儿科患者中不太为人所知，全面描述它们并建立明确的鉴别诊断至关重要。这反过来对指导治疗干预具有重要意义。
我们旨在研究：1）FND患儿的临床特征；2）FND患儿中CRPS的患病率；3）FND患儿与同时诊断为FND和CRPS的患儿在临床特征以及布达佩斯症状/体征方面的差异。
对61名诊断为FND的儿童（平均年龄：13.70 + 2.93岁；75.4%为女性）进行了研究。从病历中收集了样本的人口统计学、临床特征以及布达佩斯CRPS分类标准。
大多数FND患儿报告有感觉症状（67%）和运动症状（88%）。44%的患儿同时诊断为FND和CRPS。在这些患儿中，100%报告有感觉和运动/皮肤症状，74%有血管运动症状，65%有出汗功能症状。与单纯FND患儿相比，同时诊断的患儿中布达佩斯症状的患病率（运动功能障碍除外）显著更高。
CRPS和FND同时发生的患儿中症状和临床体征的高频率可能表明存在共同的发育机制，这对制定适当的康复干预措施很重要。
