{
  "abstract": "Background Functional neurological disorder (FND) is the most common presentation in general neurology clinic after headache, accounting for approximately one-quarter of referrals. There is growing recognition of a need for tertiary FND services to support diagnosis and treatment of complex and disabling presentations, but as clinical coding seldom picks up on functional presentations, accurate data capturing the demographics and symptomology of patients referred to such clinics is not readily available. Analysis of these factors would inform and drive funding decisions relating to commissioning of relevant services.Methods Tertiary FND service clinic letters at a regional neuroscience centre were manually interrogated for patient demographics, symptomatology and diagnosis. New patients to the service between November 2020 and December 2022 were included in the analysis.Results 207 patients were included, of which 194 (93.7%) had a new or re-confirmed diagnosis of FND at clinic. 149 (72.0%) were assigned female sex at birth and 192 (92.8%) were under 65 years of age at the time of review. A full spectrum of neurological symptoms was reported (mean of 5.9 per patient). Some of the most common symptoms reported were weakness (71.0%), sensory changes (69.0%), fatigue (65.4%), pain (61.3%), cognitive changes (55.7%), seizures (46.9%) and tremor (24.6%). 19 (9.2%) were given a new diagnosis of confirmed or probable migraine in addition to the 26 (13.4%) with an existing diagnosis of this disorder. Psychiatric co-morbidity in the FND cohort included anxiety (23.1%), depression (21.3%), post-traumatic stress disorder (12.9%) and personality disorder (6.2%). Other co-morbidities included: other functional disorder (29.9%); neurodevelopmental disorder (8.2%, including 5.7% with diagnosed autism spectrum disorder); and physical medical disorder (65.5%, comprising a broad range of body systems).Conclusions The majority of patients seen in this clinic were diagnosed with FND. The data corroborates many of the known risk factors, such as female sex, being of working age, and co-morbid psychiatric disorder. There is a particularly high prevalence of migraine, with over one-fifth of patients seen in clinic having a pre-existing or new diagnosis. There is a burden of physical medical health co-morbidity, emphasising that patients with FND often have potentially treatable symptoms that should not be discounted by assuming they are functional. The data may also reinforce growing evidence of an association with autism spectrum disorders.",
  "authors": [
    {
      "affiliations": [
        "National Institute for Health Research, Plymouth, UK"
      ],
      "name": "Marie Jasim"
    },
    {
      "affiliations": [
        "National Institute for Health Research, Plymouth, UK"
      ],
      "name": "Michael O’Gara"
    }
  ],
  "title": "#8220 Who do we meet in FND clinic? A review of the demographics and symptomology of new patients seen at a tertiary FND clinic",
  "uid": "bfd58416-d8a4-5e15-9617-2cab9213d799"
}