Presentations of Functional Neurological Symptoms following orthopaedic surgery: a retrospective case series

Abstract

Abstract

Background: This case series aimed to describe the characteristics and symptomatic profile of patients presenting with symptoms of Functional Neurological Disorder (FND) following orthopaedic surgery and explore their impact on clinical services.

Methods: This retrospective case series evaluated data from hospital clinical records of adult inpatients who presented with FND symptoms following orthopaedic surgery. Data were analysed narratively and using descriptive statistics.

Results: Five patients were included; four were female with an age range of 41 to 57 years. All five had a history of chronic pain and deteriorating mobility and three had a mental health disorder. Four patients had undergone spinal surgery and four exhibited functional motor symptoms. Length of admission ranged from 14 to 171 days and only two patients received a formal diagnosis during their inpatient stay. No local FND-specific services were available to any patients on discharge.

Conclusions: All patients with suspected FND symptoms had extended lengths of admission, which may arise from absent pre-established management pathways. Potential barriers to diagnosis may include complex clinical presentations, lack of established diagnostic pathways and a limited awareness of FND. Future research is warranted to standardise screening and management pathways within the acute orthopaedic setting.