3/31/2023 0 Comments Ms symptoms checklist disability![]() We also address difficult questions such as: “What causes functional symptoms?”, “Are they real?”, and “Is there anything that can be done?” In the second of the two articles we describe our approach to the management of functional symptoms bearing in mind the time constraints experienced by a typical neurologist. In this article we summarise an approach to the assessment and diagnosis of functional symptoms in neurology, paying attention to those symptoms that are particularly “neurological”, such as paralysis and epileptic-like attacks. As you start explaining that there’s no evidence of anything serious and that you think it’s a psychological problem, the consultation goes from bad to worse…. The patient and her husband want you to “do something”. She has already had extensive normal investigations. On examination you note intermittency of effort and clear inconsistency between her ability to walk and examination on the bed. She looks unhappy but becomes angry when you ask her whether she is depressed. Her GP has found some asymmetrical weakness in her legs and wonders if she may have developed multiple sclerosis. She is no longer able to work as a care assistant and rarely leaves the house. Her general practitioner documents a hysterectomy at the age of 25, subsequent division of adhesions for abdominal pain, irritable bowel syndrome, and asthma. A 35 year old woman is referred to your neurology clinic with a nine month history of fatigue, dizziness, back pain, left sided weakness, and reduced mobility.
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