Psychologically Informed Physical Therapy for Children and Adolescents With Functional Neurological Symptoms: The Wellness Approach

ObjectivesTo explore the opinion of todays neurologist and psychiatrist in the kingdom of Saudi Arabia regarding pathogenesis, diagnosis, treatment and outcome. It is a replication for Dutch experience with Functional Neurological symptoms Disorder (FND).MethodsA multi-centres Cross-sectional study was conducted in Saudi Arabia started from November 2019 and still ongoing. The target populations were a qualified psychiatrists or neurologists. Data were collected through an electronic questionnaire.ResultsThere were 70 respondents, 37.1% were female and 62.9% males. A 15.5% were Neurologists and 72.4% psychiatrists. Three questionnaires were taken out due to incompletion error. Most neurologists and psychiatrists believed that FND is a disorder of functioning of the nervous system together with psychogenic factors. However, 100% of psychiatrist believed that a prior psychological stress is a cause of the disorder (among other causes) while 86.84% of neurologists. Also found that, a 71% of patients who referred to neurologist were evaluated initially by a general practitioner, while 85% of the patients who referred to psychiatrist; were evaluated by neurologists. Eventually, most of the neurologists and the psychiatrists diagnosed patients by conversion disorder (13/38 of neurologist and 13/20 of psychiatrists).ConclusionOur preliminary conclusion is comparable for Dutch experience that is not considered purely a psychiatric disorder and counted disordered brain functioning together with psychogenic factors responsible for FNS. However, the majority of the psychiatrists in our study diagnose FND as conversion disorder.

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Atypical Manifestation of Polyneuropathy in Covid-19

10.5327/1516-3180.312 ◽

2021 ◽

Author(s):

Nayara de Lima Froio ◽

Ana Luisa Rosas Sarmento ◽

Sonia Maria Cesar de Azevedo Silva ◽

Lilia Azzi Collet da Rocha Camargo

Keyword(s):

Case Report ◽

Physical Therapy ◽

Sore Throat ◽

Neurological Symptoms ◽

Lower Limbs ◽

Neurological Manifestations ◽

Sensory Motor ◽

Hands And Feet ◽

Atypical Manifestation

Context: Neurological manifestations of Sars-CoV-2 are progressively emerging. Cases of Guillain-Barré syndrome and its variants, with onset about 5-10 days after influenza symptoms, have been described. This paper reports a case of polyneuropathy with onset 90 days after a sore throat episode and persistence of IgM positivity in serology for Sars- Cov-2. We aim to raise awareness of this possibility. Case Report: A 56-year-old male, hypertensive, presented with sore throat on April 21, 2020. Serology for Covid-19 was performed with positive IgM. There was complete improvement of the symptom. At the end of July, he started a symmetrical paresthesia in the feet with ascension to the knees and, on August 20, paresthesia in the hands too. So, he went to IAMSPE (SP) and tactile and painful hypoesthesia in hands and feet, hypopalesthesia in lower limbs, a fall in the lower limbs upon Mingazzini’s maneuver, global hyporeflexia and talon gait were found. Just the following tests were changed: second Covid-19 serology IgM and IgG positives; ENMG: sensory motor polyneuropathy, primarily axonal, with signs of chronicity and without signs of acute denervation in the current. Started gabapentin and physical therapy. Patient still has paresthesia in hands and feet, but with partial improvement. Conclusion: This case alerts to neurological symptoms of Covid-19 in the medium and long term.

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