ABSTRACT
It may seem surprising to be discussing psychogenic disorders in the context of the neurological examination. Surely, there will be no signs to find in a patient who does not have a neurological disease. Yet the difficulty of recognizing the signs of a psychogenic disorder should not be underestimated, and psychogenic disorders account for as many as 10–20 per cent of patients presenting to neurological clinics. The term ‘functional neurological disorder’ is now often used instead of psychogenic, but confusion can arise because the term functional is also sometimes used to denote ‘organic’ neurological disease where there is no obvious histological pathology (e.g. idiopathic dystonia), to denote neurosurgical procedures designed to alter function of the intact brain (functional neurosurgery), to denote special imaging (functional imaging) and to denote practitioners of alternative medicine (functional medicine).
