Comment by ajb
13 hours ago
This guy is probably chasing moonshine, but TBH "functional neurological disorder" sounds like one of those face-saving labels that doctors use when they don't have any idea what's going on.
13 hours ago
This guy is probably chasing moonshine, but TBH "functional neurological disorder" sounds like one of those face-saving labels that doctors use when they don't have any idea what's going on.
It is not meant to save the doctors face. The very definition of FND is "doctors dont know what is wrong, but they acknowledge that your symptoms are real".
The point of giving it a name is in the second part. Its about explicitly acknowledging the limitations of medicine
Which when it leads to abuse it's saving face and when it's incompetence it's saving face.
For a competent doctor it's used too let a patient know they're doing their job and an acknowledgement of symptoms.
Unfortunately to a _lot_ of the field "catch-all" "diagnoses" (in intentionally separating these labels). It's the same as diagnosing someone with chronic fatigue. It's diagnosing via exclusion.
The difference between chronic fatigue and brain disorders being that you're more likely to get someone looking to make a "name for themselves" diagnosing or curing the latter vs the former...
There are actually specific diagnostic criteria for FND. The BBC article mentions that the young patient showed impairment in voluntary motor behaviors, but not in involuntary behaviors (e.g. reflexes). That is characteristic of FND. Similarly, there are clear ways to distinguish FND seizures from epileptic seizures. It is not a wastebasket diagnosis at all.
“FND”… I bet they need to exercise, eat a balanced breakfast, sleep more and lower stress.
That’ll definitely pause the rapidly progressing dementia and loss of muscle control in patients in their 20s.
When doctors have no idea what something is and aren’t willing to keep trying diagnostics and interventions, it’s always “hey maybe get some more cardio and go easy on the peanut butter cups”.
To be fair, this is also what I hear from my GP when I have no complaints at all. It’s not bad advice, but I think it’s what most doctors tell patients they deem basically healthy. Nobody gets hurt by eating fewer peanut butter cups and taking the dog for a longer walk.
On one visit to my doctor, where the issue was a sports related injury, my doctor told me to get more exercise. Obviously the advice is parroted so often she just blurted it out without thinking. She knows full well I train regularly and if anything get too much exercise.
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Solid MAHA advice right there. Just eat French fries fried in beef tallow, avoid all vaccines, and whatever ails you will surely go away. Medicine isn’t actually that complicated. /s
It's a diagnosis that's made only after excluding a wide range of other potential causes for the symptoms (like brain damage, structural abnormalities, strokes, seizures, MS, infections, ...).
It's not just a case of "we don't know", it's a case of "we've looked at everything under the sun and nothing fits".
Sounds like one of those things that needs more research.
Saying to a patient "you have X" can communicate three different things:
- a casual diagnosis: your problem is caused by C
- a syndrome: you have this collection of symptoms which often appear together, we don't know what causes it, we may have some treatments that can help.
The difference between these two is often not communicated well, but they are valid diagnostic categories.
There is a bigger problem with the third one:
- we have done some investigation and don't think further investigation is worth doing.
This may be a correct judgment, or it may not. But it is not a property of the patient. Essentialising it to the patient is incorrect and potentially dangerous. Especially as, it's rarely the case that they've "looked at everything under the sun". There are many reasons for stopping before that - some of them valid, but some not.
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> needs more research.
Yes, but it also sounds like the initial stages of "research" should be taxonomy. Starting with QC'ing current testing & diagnosis standards, to have more confidence that the data is reasonably clean.
What doctor claims that everything about the human body is known? Or that they can cure everything?
“Not otherwise specified”