Abstract

Non-epileptic attack disorders (NEAD) and functional weakness present diagnostic and therapeutic challenges for both neurologists and psychiatrists. Compounded by limited hard evidence, pathways for the treatment of functional disorders are often poorly organised. This study was a historical review of 56 patient records. 45 patients had NEAD (2 with additional functional weakness) and 11 patients functional weakness only. 60.7% of patients were female, with a mean age of 44.2 years. Delay to diagnosis was 32.1 (±16.2) months. 81% of patients with functional weakness were referred from their GP, but only 51% for NEAD. No GP surgeries were identified for targeted intervention. Co-morbidities varied noticeably with diagnosis: history of epilepsy and anxiety prominent for NEAD versus other functional disorders and headache in functional weakness. Analysis of admissions data showed that for NEAD, diagnosis reduced admissions significantly, whereas this was not the case for functional weakness.

This retrospective case review suggests a potential difference in co-morbidities and response to diagnosis between patients with NEAD and patients with functional weakness, and highlights the importance of early diagnosis in NEAD.