Table 1

 Clinical signs associated with functional neurological symptoms42–46

SymptomClinical sign or observation
ParalysisVariable loss of function
Hoover’s sign
Collapsing weakness
Ipsilateral sternocleidomastoid weakness
Lack of ipsilateral facial weakness
Weakness with normal tone and reflexes
Gait and stanceFluctuating nature
Dragging of inverted or everted foot
Excessively slow movement
Romberg’s test with patient falling towards
examiner regardless of position of examiner
Walking as if on ice
Uneconomical gait
Giving way of legs with prevention of fall
SensoryWhole limb anaesthesia
Hemisensory loss for all modalities to midline
SeizuresPrecipitated by stressful situation
Duration >2 min, tendency to present as seizure status
Waxing and waning of motor activity or
prolonged limp unresponsiveness
Side to side head movements
Pelvic thrusting
Ictal or immediately postictal crying
Partial responsiveness during seizures
Closed eyes, resistance to eye opening
Unexpectedly rapid or slow recovery