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Recognition and management of functional (non-organic) symptoms after CNS damage 

Recognition and management of functional (non-organic) symptoms after CNS damage
Recognition and management of functional (non-organic) symptoms after CNS damage

Lucia Ricciardi

, Alan Carson

, and Mark Edwards


May 26, 2016: This chapter has been re-evaluated and remains up-to-date. No changes have been necessary.

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date: 19 June 2021

Patients witha recognized neurological disease or a structural damage to the central nervous system (CNS), may present with or later develop symptoms unexplained by that disease or damage (functional overlay). This chapter considers the relevance of functional overlay to management of patients with CNS damage.There are only few studies focusing on functional symptoms occurring specifically in the setting of CNS damage,nevertheless, there is an extensive literature on those patients who have an inexplicably catastrophic outcome after minor traumatic brain injury (mTBI). This evidence is reviewed as well as evidence for the diagnosis, pathophysiology, and treatment of functional symptoms.The wide phenomenology of possible symptoms is discussed as well as clinical tools for arriving at a positive diagnosis. We discuss the importance of giving and explaining the diagnosis in a suitable way to patients and their caregivers as well as management and treatment options.

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