Functional neurological disorders after COVID-19 and SARS-CoV-2 vaccines: a national multicentre observational study
Araceli Alonso‐Cánovas, Mónica Kurtis, Víctor Gómez‐Mayordomo, Daniel Macías‐García, Álvaro Gutiérrez‐Viedma, Elisabet Mondragón Rezola, Javier Pagonabarraga, Lidia Aranzabal Orgaz, Jaime Masjuán, Juan Carlos Martínez‐Castrillo, Isabel Pareés
Abstract
Functional neurological disorders (FNDs) are a common cause of neurology consultations.1 Dissociative seizures, motor and cognitive disorders are the main phenotypes. Diagnosis is made on positive terms: signs of inconsistency, incongruence and variability of physical signs with attention on clinical examination.1 Abnormal emotional processing and expectations are involved in the genesis and perpetuation of FND.1 \n \nFrom the onset of SARS-CoV-2 pandemic, world population has been affected by high levels of stress, uncertainty and misleading information, with a potential impact on mental health. Different studies have ascertained an increase of FND consultations (threefold in an emergency department).2 On the development of SARS-CoV-2 vaccines, several cases of FND following vaccination were published, as well as an official warning from the Functional Neurological Society.3 Post-COVID-19 symptoms (known as Long-COVID-19) have also become a frequent reason for neurology consultation.4 Somatic symptom disorder may be common in these patients, and socioeconomic implications are vast.5 \n \n \nOur experience is that a proportion of patients with FND describe an association with COVID-19 infection/vaccination. Here, we report a cohort of patients with FND for whom COVID-19 or SARS-CoV-2 vaccines were the main precipitant factors.