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The Inpatient Assessment and Management of Motor Functional Neurological Disorders: An Interdisciplinary Perspective

机译：电机功能性神经障碍的住院性评估和管理：跨学科视角

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Background: Motor functional neurologic disorders (FND) previously termed "hysteria" and later "con- version disorder" are exceedingly common and frequently encountered in the acute hospital setting. Despite their high prevalence, patients with motor FND can be challenging to diagnose accurately and manage effectively. To date, there is limited guidance on the inpatient approach to the neuropsychiatric evaluation of patients with functional (psychogenic) neurologic symptoms. Objective: The authors outline an inpatient multidisciplinary approach, involving neurology, psychiatry, and physical therapy, for the assessment and acute inpatient management of motor FND. Methods: A vignette of a patient with motor FND is presented followed by a discussion of general assessment principles. Thereafter, a detailed description of the neurologic and psychiatric assessments is outlined Delivery of a "rule-in" diagnosis is emphasized and specific guidance for what can be accomplished postdiagnosis in the hospital is suggested. Discussion: We encourage an interdisciplinary approach beginning at the early stages of the diagnostic assessment once an individual is suspected of having motor FND. Conclusions: Practical suggestions for the inpatient assessment of motor FND are presented. It is also important to individualize the diagnostic assessment. Future research should be conducted to test best practices for motor FND management in the acute inpatient hospital setting.
机译：背景：急性医院环境中，先前称为“歇斯斯特歇”及以后“Consteria”及以后的“Con-Version障碍”的运动功能性神经系统障碍（FND）非常普遍，并且经常遇到。尽管其普遍存在较高，但患有电机FND的患者可能具有挑战性，以准确诊断并有效地管理。迄今为止，对官能（心理学）神经系统症状患者神经精神评估的病例方法有限的指导。目的：提交人概述了一种涉及神经学，精神病学和物理治疗的住院性多学科方法，为运动FND的评估和急性住院治疗。方法：提出了一种带电机FND的患者的小插图，然后讨论了一般评估原理。此后，对神经系统和精神病学评估的详细描述是概述了“规则的”诊断，并强调了在医院可以在医院完成后诊断的具体指导。讨论：我们鼓励在诊断评估的早期阶段开始跨学科方法，一旦个人被怀疑有马达FND。结论：介绍了对电机FND的住院性评估的实用建议。个性化诊断评估也很重要。应进行未来的研究，以测试急性住院医院环境中汽车FND管理的最佳实践。

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