Features of some common explanations offered by neurologists to patients for functional disorders and their associated problems
Strategy | Comments |
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1. Making no diagnosis: no neurological disease (includes the term ‘non-organic’) | The patient is likely to go elsewhere to seek a diagnosis |
2. Making an ‘unexplained’ diagnosis, eg, these things are common in neurology and we don't really know why they happen |
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3. Making an incomplete diagnosis—eg, telling someone with a 3-week history of functional hemiparesis triggered by migraine that they just have migraine39 | This may be acceptable to the patient (and be easier for the neurologist) but leads to a missed opportunity to understand symptoms and their potential for reversibility |
4. Trying to explain that the problem is psychological—eg, explaining that these symptoms are often ‘stress-related’ |
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5. Making a functional diagnosis |
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