Beyond "buzzwords"-updated recommendations for evaluating patients presenting without la belle indifference and diagnosing functional neurological symptom disorder: A case report.

IF 0.6 Q3 MEDICINE, GENERAL & INTERNAL SAGE Open Medical Case Reports Pub Date : 2025-03-12 eCollection Date: 2025-01-01 DOI:10.1177/2050313X251325367
Jessica L Bennett, Elizabeth A Keene, Anisha Chinthalapally
{"title":"Beyond \"buzzwords\"-updated recommendations for evaluating patients presenting without la belle indifference and diagnosing functional neurological symptom disorder: A case report.","authors":"Jessica L Bennett, Elizabeth A Keene, Anisha Chinthalapally","doi":"10.1177/2050313X251325367","DOIUrl":null,"url":null,"abstract":"<p><p>La belle indifference-absence of psychological distress despite presence of significant neurological symptoms-is often highlighted in current literature as a key diagnostic criterion for functional neurological symptom disorder. However, as exemplified with this case, functional neurological symptom disorder may present without la belle indifference more commonly than previously believed. A distressed 60-year-old female presented with abdominal pain, then suddenly lost ability to speak and developed rapid, rhythmic mandible movements. Multidisciplinary examination including diagnostic evaluation of the heart, head, and neck was largely unremarkable. Following her extensive evaluation, it was revealed that she had experienced similar symptoms previously, during times of high psychological stress. A diagnosis of functional neurological symptom disorder was established, and her symptoms resolved with minimal intervention. To best serve our patients, clinicians are encouraged to perform thorough history collection and physical examination prior to obtaining costly and time-consuming diagnostic studies whenever possible. By asking about risk factors of functional neurological symptom disorder early in the patient encounter, clinicians may be able to reduce unnecessary diagnostic testing, thus minimizing patient exposure to potential risks associated with extensive diagnostic evaluation and decreasing healthcare costs.</p>","PeriodicalId":21418,"journal":{"name":"SAGE Open Medical Case Reports","volume":"13 ","pages":"2050313X251325367"},"PeriodicalIF":0.6000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905022/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"SAGE Open Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/2050313X251325367","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

La belle indifference-absence of psychological distress despite presence of significant neurological symptoms-is often highlighted in current literature as a key diagnostic criterion for functional neurological symptom disorder. However, as exemplified with this case, functional neurological symptom disorder may present without la belle indifference more commonly than previously believed. A distressed 60-year-old female presented with abdominal pain, then suddenly lost ability to speak and developed rapid, rhythmic mandible movements. Multidisciplinary examination including diagnostic evaluation of the heart, head, and neck was largely unremarkable. Following her extensive evaluation, it was revealed that she had experienced similar symptoms previously, during times of high psychological stress. A diagnosis of functional neurological symptom disorder was established, and her symptoms resolved with minimal intervention. To best serve our patients, clinicians are encouraged to perform thorough history collection and physical examination prior to obtaining costly and time-consuming diagnostic studies whenever possible. By asking about risk factors of functional neurological symptom disorder early in the patient encounter, clinicians may be able to reduce unnecessary diagnostic testing, thus minimizing patient exposure to potential risks associated with extensive diagnostic evaluation and decreasing healthcare costs.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
SAGE Open Medical Case Reports
SAGE Open Medical Case Reports MEDICINE, GENERAL & INTERNAL-
CiteScore
0.60
自引率
0.00%
发文量
320
审稿时长
8 weeks
期刊介绍: SAGE Open Medical Case Reports (indexed in PubMed Central) is a peer reviewed, open access journal. It aims to provide a publication home for short case reports and case series, which often do not find a place in traditional primary research journals, but provide key insights into real medical cases that are essential for physicians, and may ultimately help to improve patient outcomes. SAGE Open Medical Case Reports does not limit content due to page budgets or thematic significance. Papers are subject to rigorous peer review and are selected on the basis of whether the research is sound and deserves publication. By virtue of not restricting papers to a narrow discipline, SAGE Open Medical Case Reports facilitates the discovery of the connections between papers, whether within or between disciplines. Case reports can span the full spectrum of medicine across the health sciences in the broadest sense, including: Allergy/Immunology Anaesthesia/Pain Cardiovascular Critical Care/ Emergency Medicine Dentistry Dermatology Diabetes/Endocrinology Epidemiology/Public Health Gastroenterology/Hepatology Geriatrics/Gerontology Haematology Infectious Diseases Mental Health/Psychiatry Nephrology Neurology Nursing Obstetrics/Gynaecology Oncology Ophthalmology Orthopaedics/Rehabilitation/Occupational Therapy Otolaryngology Palliative Medicine Pathology Pharmacoeconomics/health economics Pharmacoepidemiology/Drug safety Psychopharmacology Radiology Respiratory Medicine Rheumatology/ Clinical Immunology Sports Medicine Surgery Toxicology Urology Women''s Health.
期刊最新文献
Beyond "buzzwords"-updated recommendations for evaluating patients presenting without la belle indifference and diagnosing functional neurological symptom disorder: A case report. Melano-erythrodermic folliculotropic mycosis fungoides misdiagnosed as a case of recalcitrant atopic dermatitis: A case report. Uncomplicated full-term birth after laparoscopical salpingotomy as organ-preserving therapy of naturally conceived heterotopic pregnancy: A case report. Combined autologous hematopoietic stem cell transplantation and CD19 CAR T-cell therapy for relapsed/refractory diffuse large B-cell lymphoma with TP53 mutation: A case report. A case of altruistic suicide by severe carbon monoxide poisoning.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1