I recently cared for a young woman who was diagnosed with functional neurological disorder. She was extremely impacted by it to the point of cachexia, heart failure, and multiple codes, two of which occurred on my floor alone. Obviously her case was quite extreme, as her family's beliefs about folk medicine caused them to delay seeking care until the damage was largely irreversible.
Not a single one of her caregivers were willing to accept it as her diagnosis. They were willing to believe her issues were stemming from a couple of far less likely scenarios that I won't detail for reasons of confidentiality, but trust me when I say that they were outlandish at best. Her outcome was very poor, and even though we discharged her months ago I still think of her occasionally. She'll be one of those rare patients that stick in the back of my mind for a long time.
I don't have much experience dealing with these types of patients due to the kind of floor I work on, but discussing her case with the neurology team was very eye-opening to me. It got me wondering about how common this type of disorder really is.
How often do you see it in the wild, and more importantly, how do you help patients and families come to accept it as their diagnosis?
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