MHM Magazine

Issue 2 | 2022 | MENTAL HEALTH MATTERS | 33 MHM Functional disorders are conditions, such as irritable bowel syndrome, fibromyalgia, and functional neurological symptom disorder (FNSD) — whose origin arises primarily from a disorder of nervous system functioning rather than clearly identifiable pathophysiological disease. They are the second most common reason for new neurology consultations. The exact prevalence of FNSD is unknown, however an estimated incidence rate of between 4 and 12 per 100 000 population per year has been reported. One definition of FNSD is as a disorder of the voluntary motor or sensory system, with symptoms that can be positively identified as internally consistent or incongruent with recognised pathophysiological disease. It’s recognised in ICD-11 as an acute dissociative disorder with neurological symptoms. FNSD is common in emergency, primary care, neurological and psychiatric settings. It may include psychogenic non epileptic seizures (PNES), functional movement disorders like dystonias, weakness and paralysis, speech symptoms, and visual symptoms. It causes considerable physical disability and distress, loss of work hours, and is characterised by looping pathways through healthcare services, which places a huge economic burden both on patients and health services. Dr Laila Paruk, Psychiatrist, Johannesburg drparuk@psychiatryvillagemed.co.za FUNCTIONAL NEUROLOGICAL SYMPTOM DISORDERS