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Advisor(s)
Abstract(s)
Introdução: A Perturbação de Sintomas Neurológicos Funcionais (PSNF), também
conhecida como Perturbação Conversiva (PC), define-se pela presença de um ou mais
sintomas ou défices na função motora ou sensorial, incompatíveis com mecanismos
fisiopatológicos conhecidos, não sendo, portanto, mais bem explicados por outra
condição médica. A sintomatologia não é intencional nem voluntária e este quadro
clínico causa prejuízo significativo em vários contextos da vida diária do doente.
Classicamente, o diagnóstico era realizado após exclusão de causa médico-cirúrgica.
Existem, no entanto, sinais do exame neurológico e do estado mental, que podem ser
avaliados e contribuir positivamente para um diagnóstico de Perturbação de Sintomas
Neurológicos Funcionais – os sinais positivos.
Método: A informação para a realização desta dissertação foi obtida através da pesquisa
realizada nas bases de dados eletrónicas PubMed, b-on e ResearchGate. Os critérios de
inclusão foram: publicações que abordassem a validade de sinais positivos em doentes
com Perturbação de Sintomas Neurológicos Funcionais; artigos publicados entre 2014 e
2023 inclusive; idade avaliada igual ou superior a 18 anos e foram apenas considerados
para esta revisão artigos em inglês e português. Foi também utilizado o Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition.
Rsultados: Foram descritos 21 sinais positivos avaliados através de testes com uma
metodologia pré-definida, 19 motores incluindo 2 motores da marcha e 2 sensoriais.
Conclusão: Os sinais apresentados mostram diferentes graus de fiabilidade e continua
a ser necessário o estudo mais aprofundado das suas validades, no entanto, estes
mostram ser um contributo útil, complemento para um diagnóstico mais eficiente desta
patologia. O reconhecimento destes sinais por parte do profissional de saúde pode
colaborar para um diagnóstico mais precoce, muitas vezes menos invasivo e levar a uma
melhor gestão de recursos.
Introduction: Functional Neurological Disorder (FND), also known as Conversion Disorder (CD), is defined by the presence of one or more symptoms or deficits in motor or sensory function, incompatible with known pathophysiological mechanisms, and is therefore not better explained by another medical condition. The symptoms are neither intentional nor voluntary and this clinical condition causes significant impairment in various contexts of the patient's daily life. Classically, the diagnosis was made after excluding a medical-surgical cause. There are, however, signs of neurological examination and mental status, which can be evaluated and contribute positively to a diagnosis of Functional Neurological Disorder – positive signs. Methods: The information for this dissertation was obtained through research carried out in the electronic databases PubMed, b-on and ResearchGate. The inclusion criteria were: publications that addressed the validity of positive signs in patients with Functional Neurological Disorder; articles published between 2014 and 2023 inclusive; assessed age equal to or greater than 18 years and were only considered articles in English and Portuguese. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition was also used. Results: 21 positive signals were described, 19 motors, including 2 walking motors and 2 sensory. Conclusion: The signs presented show different degrees of reliability and further study of their validity continues to be necessary, however, they prove to be a useful contribution, a complement for a more efficient diagnosis of this pathology. The recognition of these signs by health professionals can contribute to an earlier, often less invasive diagnosis and lead to better resource management.
Introduction: Functional Neurological Disorder (FND), also known as Conversion Disorder (CD), is defined by the presence of one or more symptoms or deficits in motor or sensory function, incompatible with known pathophysiological mechanisms, and is therefore not better explained by another medical condition. The symptoms are neither intentional nor voluntary and this clinical condition causes significant impairment in various contexts of the patient's daily life. Classically, the diagnosis was made after excluding a medical-surgical cause. There are, however, signs of neurological examination and mental status, which can be evaluated and contribute positively to a diagnosis of Functional Neurological Disorder – positive signs. Methods: The information for this dissertation was obtained through research carried out in the electronic databases PubMed, b-on and ResearchGate. The inclusion criteria were: publications that addressed the validity of positive signs in patients with Functional Neurological Disorder; articles published between 2014 and 2023 inclusive; assessed age equal to or greater than 18 years and were only considered articles in English and Portuguese. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition was also used. Results: 21 positive signals were described, 19 motors, including 2 walking motors and 2 sensory. Conclusion: The signs presented show different degrees of reliability and further study of their validity continues to be necessary, however, they prove to be a useful contribution, a complement for a more efficient diagnosis of this pathology. The recognition of these signs by health professionals can contribute to an earlier, often less invasive diagnosis and lead to better resource management.
Description
Keywords
Perturbação Conversiva Perturbação dos Sintomas Neurológicos Funcionais Sinais Positivos Validade