1.上海交通大学医学院附属瑞金医院精神心理科,上海 200025
2.上海中医药大学附属市中西医结合医院脑病科, 上海 200082
3.上海交通大学医学院附属瑞金医院神经内科,上海 200025
Received:03 February 2024,
Revised:2024-03-31,
Accepted:02 April 2024,
Published:28 May 2024
移动端阅览
张晶璟,冯蓓蕾,王刚.功能性神经疾病治疗进展[J].重庆医科大学学报,2024,49(5):638-642.
Zhang Jingjing,Feng Beilei,Wang Gang.Advances in the treatment of functional neurological disorders[J].Journal of Chongqing Medical University,2024,49(5):638-642.
张晶璟,冯蓓蕾,王刚.功能性神经疾病治疗进展[J].重庆医科大学学报,2024,49(5):638-642. DOI: 10.13406/j.cnki.cyxb.003494.
Zhang Jingjing,Feng Beilei,Wang Gang.Advances in the treatment of functional neurological disorders[J].Journal of Chongqing Medical University,2024,49(5):638-642. DOI: 10.13406/j.cnki.cyxb.003494.
功能性神经系统疾病(functional neurological disorders,FND)是指临床表现为神经系统疾病症状,但无相应器质性病因的一类疾病。临床上,此类疾病诊断困难,患者及家属对诊断的认可程度低,治疗缺乏统一规范性指南指导,本文从药物、心理、康复、中医、功能神经外科等多种治疗手段进行综述,建议开展多学科诊疗模式,制定个体化治疗计划,以期造福更多患者。
Functional neurological disorders(FND) refer to a group of diseases characterized by the clinical symptoms of neurological disorders, but without corresponding organic causes. In clinical practice,the diagnosis of such diseases is difficult, and patients and their families have low recognition of the diagnosis; moreover, there is a lack of unified and standardized guidelines for treatment. This article reviews various treatment methods such as medication, psychology,rehabilitation,traditional Chinese medicine, and functional neurosurgery, and it is recommended to develop a multidisciplinary diagnosis and treatment model and formulate individualized treatment plans, so as to bring benefits to more patients.
Hallett M , Aybek S , Dworetzky BA , et al . Functional neurological disorder:new subtypes and shared mechanisms [J ] . Lancet Neurol , 2022 , 21 ( 6 ): 537 - 550 .
王金涛 , 王 刚 . 功能性神经系统疾病分类与诊断标准 [J ] . 中国现代神经疾病杂志 , 2023 , 23 ( 2 ): 138 - 142 .
Wang JT , Wang G . Classification and diagnostic criteria of functional neurological disorder [J ] . Chin J Contemp Neurol Neurosurg , 2023 , 23 ( 2 ): 138 - 142 .
王 刚 , 高 颖 , 邹 扬 , 等 . 震颤的电生理评估 [J ] . 诊断学理论与实践 , 2016 , 15 ( 2 ): 199 - 201 .
Wang G , Gao Y , Zou Y , et al . Electrophysiological evaluation of tremor [J ] . J Diagn Concepts Pract , 2016 , 15 ( 2 ): 199 - 201 .
邹 扬 , 王 刚 . 生理学发现:震颤和肌阵挛 [M ] //Hallet M. 心因性运动障碍和其他转换障碍 .王 刚, 译 . 2版,上海: 上海交通大学出版社 , 2020 : 210 ⁃ 215 .
Zou Y , Wang G . Physiological discoveries: tremors and clonus [M ] //Hallet M. Psychogenic motor disorders and other conversion disorders . Wang G, trans. 2nd ed. Shanghai : Shanghai Jiaotong University Press , 2020 : 210 - 215 .
汤 然 , 王金涛 , 王 刚 . 功能性运动障碍影像学研究进展 [J ] . 中国现代神经疾病杂志 , 2023 , 23 ( 12 ): 1087 - 1092 .
Tang R , Wang JT , Wang G . Advances on neuroimaging of functional movement disorder [J ] . Chin J Contemp Neurol Neurosurg , 2023 , 23 ( 12 ): 1087 - 1092 .
Mishra A , Pandey S . Functional neurological disorders:clinical spectrum,diagnosis,and treatment [J ] . Neurologist , 2022 , 27 ( 5 ): 276 - 289 .
Perez DL , Aybek S , Popkirov S , et al . A review and expert opinion on the neuropsychiatric assessment of motor functional neurological disorders [J ] . J Neuropsychiatry Clin Neurosci , 2021 , 33 ( 1 ): 14 - 26 .
Stone J , Edwards M . Trick or treat? Showing patients with functional(psychogenic) motor symptoms their physical signs [J ] . Neurology , 2012 , 79 ( 3 ): 282 - 284 .
Edwards MJ , Yogarajah M , Stone J . Why functional neurological disorder is not feigning or malingering [J ] . Nat Rev Neurol , 2023 , 19 ( 4 ): 246 - 256 .
Espay AJ , Aybek S , Carson A , et al . Current concepts in diagnosis and treatment of functional neurological disorders [J ] . JAMA Neurol , 2018 , 75 ( 9 ): 1132 - 1141 .
Rommelfanger KS . The role of placebo in the diagnosis and treatment of functional neurologic disorders [J ] . Handb Clin Neurol , 2016 , 139 : 607 - 617 .
施慎逊 , 吴文源 . 中国焦虑障碍防治指南 [M ] . 2版 . 北京 : 中华医学电子音像出版社 , 2023 : 240 - 241 .
Shi SX , Wu WY . Guide to prevention and treatment of anxiety disorder in China [M ] . 2nd ed . Beijing : China Medical Electronic Audio Visual Publishing House , 2023 : 240 - 241 .
Butler M , Seynaeve M , Nicholson TR , et al . Psychedelic treatment of functional neurological disorder:a systematic review [J ] . Ther Adv Psychopharmacol , 2020 , 10 : 2045125320912125 .
Dreissen YE , Lambert F , Dijk JM , et al . Botulinum neurotoxin (BoNT) treatment in functional movement disorders:long-term follow-up [J ] . J Neurol Neurosurg Psychiatry , 2020 , 91 ( 10 ): 1120 - 1121 .
Dreissen YEM , Dijk JM , Gelauff JM , et al . Botulinum neurotoxin treatment in jerky and tremulous functional movement disorders:a double-blind,randomised placebo-controlled trial with an open-label extension [J ] . J Neurol Neurosurg Psychiatry , 2019 , 90 ( 11 ): 1244 - 1250 .
Espay AJ , Ries S , Maloney T , et al . Clinical and neural responses to cognitive behavioral therapy for functional tremor [J ] . Neurology , 2019 , 93 ( 19 ): e1787 - e1798 .
Beal EM , Coates P , Pelser C . Psychological interventions for treating functional motor symptoms:a systematic scoping review of the literature [J ] . Clin Psychol Rev , 2022 , 94 : 102146 .
Goldstein LH , Robinson EJ , Chalder T , et al . Six-month outcomes of the CODES randomised controlled trial of cognitive behavioural therapy for dissociative seizures:a secondary analysis [J ] . Seizure , 2022 , 96 : 128 - 136 .
O'Connell N , Watson G , Grey C , et al . Outpatient CBT for motor functional neurological disorder and other neuropsychiatric conditions:a retrospective case comparison [J ] . J Neuropsychiatry Clin Neurosci , 2020 , 32 ( 1 ): 58 - 66 .
Hinson VK , Weinstein S , Bernard B , et al . Single-blind clinical trial of psychotherapy for treatment of psychogenic movement disorders [J ] . Parkinsonism Relat Disord , 2006 , 12 ( 3 ): 177 - 180 .
Baslet G , Ridlon R , Raynor G , et al . Sustained improvement with mindfulness-based therapy for psychogenic nonepileptic seizures [J ] . Epilepsy Behav , 2022 , 126 : 108478 .
Godena EJ , Perez DL , Crain LD , et al . Psychotherapy for functional neurological(conversion) disorder:a case bridging mind,brain,and body [J ] . J Clin Psychiatry , 2021 , 82 ( 6 ): 21ct14246 .
Chen DK , Maheshwari A , Franks R , et al . Brief group psychoeducation for psychogenic nonepileptic seizures:a neurologist-initiated program in an epilepsy center [J ] . Epilepsia , 2014 , 55 ( 1 ): 156 - 166 .
Schmidt T , Ebersbach G , Oelsner H , et al . Evaluation of individualized multi-disciplinary inpatient treatment for functional movement disorders [J ] . Mov Disord Clin Pract , 2021 , 8 ( 6 ): 911 - 918 .
Ghrouz A , Marco E , Muñoz-Redondo E , et al . The effect of motor relearning on balance,mobility and performance of activities of daily living among post-stroke patients:study protocol for a randomised controlled trial [J ] . Eur Stroke J , 2022 , 7 ( 1 ): 76 - 84 .
Molero-Mateo P , Molina-Rueda F . Physiotherapy for patients with functional movement disorder:a systematic review [J ] . Neurologia , 2023 : S2173-S5808(23)00033 - 0 .
Grippe T , Desai N , Arora T , et al . Use of non-invasive neurostimulation for rehabilitation in functional movement disorders [J ] . Front Rehabil Sci , 2022 , 3 : 1031272 .
Gonsalvez I , Spagnolo P , Dworetzky B , et al . Neurostimulation for the treatment of functional neurological disorder:a systematic review [J ] . Epilepsy Behav Rep , 2021 , 16 : 100501 .
Nicholson C , Edwards MJ , Carson AJ , et al . Occupational therapy consensus recommendations for functional neurological disorder [J ] . J Neurol Neurosurg Psychiatry , 2020 , 91 ( 10 ): 1037 - 1045 .
林宇栋 , 冯蓓蕾 , 王 刚 . 从古医案浅析中医对功能性运动障碍的诊断与治疗 [J ] . 中国现代神经疾病杂志 , 2023 , 23 ( 12 ): 1072 - 1075 .
Lin YD , Feng BL , Wang G . Analysis of traditional Chinese medicine's understanding of functional movement disorder from ancient medical records [J ] . Chin J Contemp Neurol Neurosurg , 2023 , 23 ( 12 ): 1072 - 1075 .
魏之琇 . 续名医类案 [M ] . 北京 : 人民卫生出版社 , 1982 : 560 - 562 .
Wei ZX . Xu ming yi lei an [M ] . Beijing : People's Medical Publishing House , 1982 : 560 - 562 .
刘跂 . 钱仲阳传 [M ] //段逸山. 医古文 . 上海 : 上海科学技术出版社 , 1995 : 7 - 12 .
Liu Q . Biography of Qian Zhongyang [M ] //Duan YS. Classical literature of traditional Chinese medicine . Shanghai : Shanghai Scientific and Technical Publishers , 1995 : 7 - 12 .
俞震 . 古今医案按 [M ] . 北京 : 北京科学技术出版社 , 2014 : 251 .
Yu Z . Gu jin yi an an [M ] . Beijing : Beijing Science and Technology Press , 2014 : 251 .
孙天祎 , 马良宵 , 张 洲 , 等 . 基于古今文献的运动障碍选穴规律探析 [J ] . 世界科学技术-中医药现代化 , 2021 , 23 ( 8 ): 2871 - 2877 .
Sun TY , Ma LX , Zhang Z , et al . Study on the point selection pattern of movement disorders based on ancient and modern literature [J ] . Mod Tradit Chin Med Mater Med World Sci Technol , 2021 , 23 ( 8 ): 2871 - 2877 .
Rijn VMA , Munts AG , Marinus J , et al . Intrathecal baclofen for dystonia of complex regional pain syndrome [J ] . Pain , 2009 , 143 ( 1 ): 41 - 47 .
Langevin JP , Skoch JM , Sherman SJ . Deep brain stimulation of a patient with psychogenic movement disorder [J ] . Surg Neurol Int , 2016 , 7 ( Suppl 35 ): S824 - S826 .
Marsili L , Keeling EG , Maciel R , et al . Functional movement disorders and deep brain stimulation:a multi-center study [J ] . Movement Disord Clin Pract , 2023 , 10 ( 1 ): 94 - 100 .
0
Views
15
下载量
0
CSCD
Publicity Resources
Related Articles
Related Author
Related Institution
京公网安备11010802024621
