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

Kenneith Yong, Richard F. M. Chin, Jay Shetty, Kirsty Hogg, Kieran Burgess, Max Lindsay, Ailsa McLellan, Jon Stone, Krishnaraya KamathTallur, the Edinburgh Paediatric FND Study Group

To report incidence, demographic and clinical characteristics, and symptom outcome of functional neurological disorder (FND) in children. 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. 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. At this regional centre, FND in children had a higher incidence than previously reported and a less optimistic outcome than in some other studies.