Comparison of outcomes and prognostic factors with previous studies of functional motor and sensory symptoms*
| Year | Sample size | Population sampled | Mean years of follow up | Neurological disorder missed (clinical features) | Disability at follow up | Prognostic factors | |
|---|---|---|---|---|---|---|---|
| *Excluding studies with high proportions of other functional neurological symptoms, for example non-epileptic attacks, pain, non-organic visual symptoms. | |||||||
| **Length of time after assessment (mean 3.75 years after symptom onset). | |||||||
| †Two patients with visual symptoms and seven with pseudoepileptic attacks also reported. | |||||||
| (Three studies report limited data on motor symptoms alone: Carter (1946)10: 22% unchanged or worse at five years; Ljungberg (1957)11: 32% unchanged or worse at five years; Mace and Trimble (1996)12: 34% not improved at 10 years.) | |||||||
| Couprie et al7 | 1995 | 56 | Neurological inpatients; 73% weakness, 12% gait, 5% sensory only; retrospective | 4.5 | 2 cases (1 bizarre transient paralysis due to cerebral ischaemia; 1 ataxia with posturing due to multiple sclerosis) | 41% with Rankin scores worse than 2 (“I have symptoms which have caused some changes in my life but I am still able to look after myself”) | Positive: recent onset and recovery by the time of discharge |
| Crimlisk et al8 | 1998 | 64 | Neurological inpatients; 50% weakness, 50% movement disorder; retrospective | 6 | 3 cases (all gait disorder, due to (1) myotonic dystrophy, (2) spinocerebellar degeneration, and (3) paroxysmal hemidystonia) | 50% had either retired on grounds of ill health or were on sick leave; 36% had a psychiatric disorder | Positive: symptoms present for less than one year; the presence of an axis 1 psychiatric disorder. Negative: receipt of benefits, and litigation |
| Binzer and Kullgren 9 | 2000 | 30 | Neurological inpatients; 100% weakness; prospective | 1** | None | 43% not working at 1 year | Negative: the presence of a personality disorder, hopelessness, and a concurrent somatic diagnosis |
| Moene16 | 2000 | 76† | Psychiatric in- and outpatients; 58% weakness or movement disorder, 37% motor and sensory, 5% sensory | 2.4 | 10 cases (1 weakness due to ALS; 5 movement disorders proven to be organic; 3 gait disorders due to MS, MSA, and dementia; 1 leg pain due to radicular disease) | Not stated | Higher age at onset, longer duration of symptoms and “suspicion of neurological disorder” predicted misdiagnosis |
| This study | 2002 | 47 | Neurological inpatients; 55% weakness, 45% sensory only; retrospective | 12.5 | 1 case (intermittent paresis due to multiple sclerosis) | 30% taken medical retirement; 38% limited in moderate activities; 43% with severe or very severe pain | Positive: sensory symptoms and signs alone rather than weakness and/or sensory symptoms |