Trial By Error

Tag: FND

  • A Letter Requesting Corrections of Inflated Prevalence Rates in Nine More FND Papers

    Several colleagues and I recently wrote to the journal NeuroImage: Clinical to request a correction in a 2021 article about functional neurological disorder (FND). The article included the false claim that a seminal 2010 study found that FND was the second-most-common diagnosis at outpatient neurology clinics. In fact, FND—called conversion disorder at the time—was the…

  • FND Experts Agree To Correct Inflated Prevalence Claim

    For years, experts in functional neurological disorder (FND) have cited a seminal study in their field to claim that the diagnosis was the second-most-common presentation at outpatient neurology clinics, with a prevalence of 16%. This claim was, and is, categorically untrue. The Scottish Neurological Symptoms Study (SNSS), which yielded multiple papers about a dozen years…

  • A Letter Regarding Inflated Prevalence Rates for Functional Neurological Disorder

    I have posted previously about how papers on functional neurological disorder (FND) have routinely mis-cited a seminal 2010 study in asserting that the diagnosis is the second-most-common presentation at neurology clinics, with a rate of 16%. In fact, the 2010 study found that only 5.5% had FND, the new name for the antiquated Freudian construct…

  • Questions About the Prevalence of Functional Neurological Disorder and the Research on Hoover’s Sign for Functional Leg Weakness

    (This is a long-ish post. Sorry! It covers two complicated issues. I want to thank an intrepid source for help with this.) I have great sympathy for patients diagnosed with functional neurological disorder (FND). Their symptoms can be seriously disabling and their plight has long been neglected and dismissed by the medical establishment. When I…

  • Mt Sinai’s David Putrino on Long Covid and Functional Neurological Disorder

    David Putrino is a neuroscientist and physical therapist at New York’s Mt Sinai Health System, where he is director of rehabilitation innovation. Over the last three years, he has worked extensively with patients experiencing prolonged symptoms after an acute bout of Covid-19, or what has become known as long Covid (LC). Last spring, I interviewed…

  • Can Functional Neurological Disorder Be an Indication of Prion Disease?

    A recent article in the Journal of Neurology presents a twist on the issue of functional neurological disorder (FND). The article, which was published in September, is called “Functional neurological symptoms as initial presentation of Creutzfeldt‐Jakob disease: case series.” Creutzfeldt-Jakob disease is a prion disorder that leads to dementia and death, usually within months. But…

  • Brain Publishes Letter About Flawed Study from NYU on ‘Psychogenic POTS’

    When I have previously written about functional neurological disorder, or FND, I have gotten flack from FND patients. I understand from these exchanges that some have taken what I have written as criticizing patients with these diagnoses or dismissing their suffering. That is certainly not my intention. I know these conditions can be extremely disabling.…

  • A Letter About the Inflated Prevalence Rate of Functional Neurological Disorder

    I have recently written two posts (here and here) about how experts in functional neurological disorder (FND) have a tendency to assert prevalence rates that ignore their own diagnostic criteria. Today I sent a letter to the corresponding author of yet another paper that has similarly engaged in this problematic strategy. I have posted the…

  • An FND Patient’s View–and More on Those Inflated Prevalence Rates

    In a post last week, I noted that experts in FND have a tendency to assert prevalence rates that ignore their own diagnostic criteria. Before offering further thoughts on that score, I want to make one point very explicit: I am in no way questioning whether people with the diagnosis have serious disorders and very…

  • Does Functional Neurology Disorder Account for a Third of Outpatient Neurology Consults?

    Functional neurological disorder, or FND, is the new-ish name for the hoary Freudian construct known as conversion disorder. For decades, psychiatrists informed patients that they were “converting” their emotional distress and anxieties into physical symptoms like tremors, seizures, sensory and cognitive deficits, a halting gait, or other physical dysfunctions. The impossibility of proving such claims…

  • My Letter to Author of CODES Commentary

    Earlier today, I sent the following letter to Dr David Perez, a neurologist and psychiatrist at Massachusetts General Hospital in Boston. Dr Perez, an expert on functional neurological disorders, wrote a commentary for Lancet Psychiatry that accompanied the publication of the results for CODES, a major study of cognitive behavior therapy as a treatment for…

  • CODES Trial Commentary Promotes ‘Eminence-Based Medicine’

    By all accounts, the recently published CODES trial was the most authoritative study to date of whether cognitive behavior therapy (CBT) was an effective treatment for so-called dissociative seizures–a point confirmed in a commentary accompanying the paper in Lancet Psychiatry. Unfortunately, the CODES investigators and the commentary author seem to interpret the null results for…