Functional neurological disorder in children and young people: Incidence, clinical features, and prognosis

Abstract

Aim: To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children. Method: Children diagnosed with FND at a regional children's hospital were prospectively recruited by weekly active surveillance for 36 months. Demographic, clinical, and follow-up data were retrospectively extracted by review of electronic records. Descriptive statistical analyses were used. Results: Ninety-seven children (age range 5–15 years) met the case definition of FND (annual incidence 18.3 per 100 000 children). Children with FND were likely to be female (n = 68 [70%]) and older (median 13 years) with no difference in the Scottish Index of Multiple Deprivation (marker of socioeconomic status) compared with the general childhood population. Functional motor (41%) and sensory (41%) symptoms were most common; other somatic symptoms such as headache (31%) and pain (27%) were frequent. Self-reported psychiatric symptoms and infection/inflammation were the most common predisposing and precipitating factors respectively. At a median of 15 months follow-up, 49% of 75 children reported improvement or resolution of FND symptoms with no prognostic factors found. Interpretation: At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.