200 Section - Pediatric Rehabilitation Outcomes in Functional neurological Disorder(FND)

Case Diagnosis: Patient is a16-year old female with symptoms of extreme fatigue, dizziness, brain fog, and intermittent tachycardia post Covid. She was diagnosed with POTS; weakness causing difficutly ambulating. She had episodes of mutsim attributed to vocal cord weakness, occasional muscle spasms, jerking of extremities, difficulty swallowing, dizziness and generalized fatigue. Slow progress reported with outpatient physical, occupational and speech therapies, prompted admission to inpatient rehabilitation for intensive therapies.

Case Description: Patient reported sensitivity to tactile stimuli, and noise, difficulties in crowds and intolerance to sun exposure. She reported episodes of discomfort on her scalp, trying to pull her hair out, requiring family intervention with few solutions. Examination revealed normal strength and sensation and independent standing; posturing and twisting observed when coming to standing. She received PT,OT,SLP, psychology support. With OT- WeeFIMs improved from 34 to 55;PT improved from 16 to 35; SLP implemented diaphragmatic breathing exercises; incorporated vocal cord hygiene strategies; completed higher cognitive linguistic activities within a generalized environment; monitored swallow coordination during meals.

Discussions: FND is a syndrome involving atypical neurologic symptoms not corresponding to or explained by other neurological or medical disorders. It is an umbrella term including functional symptoms across multiple physiological systems with disturbances in neurophysiologic regulation with a multifactorial etiology. It is the 2nd most common neurological condition following headache. It can be part of functional GI disorders, psychiatric conditions, chronic pain, chronic fatigue, POTS. Disgnostic criteris are beneficial with addressing associated issues to provide adequate, individualized care.

Conclusions: This case demonstrates the importance of accurate diagnosis following a complete history and physical examination. Therapy is beneficial in management of FND. Standardized scoring systems(eg: WeeFIM, PAMS) allow for objective evaluation of functional gains through hospitalization. It is also important to provide patients with adequate support systems post discharge.