A new study uncovers concerns about misdiagnosis, stigma and inconsistent care for people with autoimmune diseases who are also diagnosed with functional neurological disorder (FND).

It also reveals deep disagreements between clinicians over FND diagnoses.

The research team say better communication, multidisciplinary working and more holistic care are needed to improve patient outcomes.

Lead author Dr Melanie Sloan, from UEA’s Norwich Medical School and the Department of Public Health at the University of Cambridge, said: “FND is a recognised neurological condition that can cause symptoms such as weakness, shaking, changes in movement or feeling, and non-epileptic seizures.

“These symptoms are real and are not made up or under a person's control.

“We wanted to better understand the challenges of diagnosing complex neurological symptoms in autoimmune diseases, and why patients and clinicians can sometimes see things very differently.

“Ultimately, our aim was to identify practical ways to improve communication, reduce distress and help ensure patients receive the most appropriate care and support.”

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[–] [S] 2 points 1 week ago

Only seven per cent agreed with being told that their symptoms were “psychosomatic”.

Doctors taking part in the study described how difficult it can be to work out what is causing symptoms. Many said they had little training in FND and others had very strong opinions either for or against FND diagnoses.

Patients and doctors reported examples of symptoms being put down to the wrong cause, with misdiagnoses reported in both directions.

Dr Sloan said: “We still do not know enough about some of the ways autoimmune diseases affect the brain and nervous system to always be certain what is causing a particular symptom.

“FND is a real condition and people with FND need the right treatment. But we need to be careful about assuming we know the cause of every symptom and coming to quick conclusions. There may be many different causes of neurological symptoms in autoimmune diseases which are very hard to untangle.

“Clearer explanations of diagnoses could help patients understand and accept them, while doctors need to be cautious when the cause of symptoms is not clear.”

Doctors are fallible and should listen to their patients more? No way..... /s

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