Cabreira Verónica, McLoughlin Caoimhe, Shivji Natasha, Lodge Alexandra, Rhijn Sanne Van, Keynejad Roxanne C, Coebergh Jan, Carson Alan, Stone Jon, Lehn Alex, Hoeritzauer Ingrid
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Central and North West London NHS Foundation Trust, London, UK.
BJPsych Bull. 2024 Oct 11:1-11. doi: 10.1192/bjb.2024.70.
Functional neurological disorder (FND) most often presents in women of childbearing age, but little is known about its course and outcomes during pregnancy, labour and postpartum (the perinatal period). We searched MEDLINE, PsycInfo and Embase combining search terms for FND and the perinatal period. We extracted data on patient demographics, subtype of FND, timing of symptom onset, comorbidities, medications, type of delivery, investigations, treatment, pregnancy outcomes and FND symptoms at follow-up.
We included 36 studies (34 case reports and 2 case series) describing 43 patients. Six subtypes of FND were identified: functional (dissociative) seizures, motor weakness, movement disorder, dissociative amnesia, speech disorders and visual symptoms. New onset of perinatal FND was more common in the third trimester and onwards. Some women with functional seizures were exposed to unnecessary anti-seizure prescriptions and intensive care admissions.
Prospective studies are urgently needed to explore how FND interacts with women's health in the perinatal period.
功能性神经障碍（FND）最常出现在育龄女性中，但对于其在孕期、分娩期及产后（围产期）的病程和结局知之甚少。我们在MEDLINE、PsycInfo和Embase数据库中进行检索，将FND和围产期的检索词相结合。我们提取了关于患者人口统计学、FND亚型、症状发作时间、合并症、用药情况、分娩方式、检查、治疗、妊娠结局以及随访时FND症状的数据。
我们纳入了36项研究（34例病例报告和2个病例系列），共描述了43例患者。确定了FND的六种亚型：功能性（分离性）癫痫发作、肌无力、运动障碍、分离性遗忘、言语障碍和视觉症状。围产期FND的新发情况在孕晚期及以后更为常见。一些患有功能性癫痫发作的女性接受了不必要的抗癫痫药物治疗和重症监护。
迫切需要进行前瞻性研究，以探讨FND在围产期如何与女性健康相互作用。
