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Original article
Long-term outcomes of functional neurological disorder in children
  1. Joseph Raper1,
  2. Victoria Currigan1,
  3. Sarah Fothergill2,
  4. Jon Stone3,
  5. Rob J Forsyth4
  1. 1 Paediatric Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2 Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
  3. 3 Centre for Clinical Brain Sciences, University of Edinburgh Division of Health Sciences, Edinburgh, UK
  4. 4 Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
  1. Correspondence to Dr Rob J Forsyth, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE1 7RU, UK; rob.forsyth{at}newcastle.ac.uk

Abstract

Objectives To establish the incidence and long-term outcomes (up to 21 years) of children presenting to a University hospital paediatric neurology service with symptoms due to functional neurological disorder (FND) with particular reference to occurrence of FND or similar symptoms in adulthood.

Methods Retrospective chart review to determine characteristics of the original paediatric FND presentation plus record-linkage with providers of Child and Adolescent Mental Health Services. Chart review of adult medical records for documentation of functional symptoms in adulthood.

Results 124 individuals (56% female) met entry criteria. The most common presentations were seizures (18%), sensory loss (18%) and motor symptoms (16%). Frequency gradually increased with age of onset with an incidence in paediatric neurological services of 6 per 100 000 children under 16. In up to 21 years’ follow-up (median 8.3 years), 114/124 attained their 16th birthdays by the study census date and were thus eligible for inclusion in an analysis of symptom persistence/recurrence in adulthood. 26/114 (23%) showed evidence of FND in adulthood of sufficient significance to be recorded in medical records.

Conclusion Paediatric FND is commoner than previous estimates. Even in this selected population of children reaching specialist paediatric neurology services, a high long-term remission rate is observed.

  • neurology
  • adolescent health
  • child psychology
  • child psychiatry

https://doi.org/10.1136/archdischild-2018-316519

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    Footnotes

    • Contributors RJF conceptualised and designed the study, coordinated and supervised data collection, drafted the initial manuscript, carried out the initial analyses and reviewed and revised the manuscript. JR, VC and SF designed data collection instruments, collected data, carried out the initial analyses and reviewed and revised the manuscript. JS designed the study, carried out the initial analyses and critically reviewed the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval North East Newcastle & North Tyneside 1 Research Ethics Committee (reference 16NE0401) and the national Confidentiality Advisory Group of the NHS Health Research Authority (reference 17/CAG/0047).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.

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