Diagnosis of acute motor functional disorders through semiology.

Abstract

Motor functional neurological disorders (FND) are a group of manifestations in movement and strength that present internal inconsistency with any other neurological disease. Objective: to evaluate the adequacy of semiological maneuvers, in an emergency scenario, to demonstrate motor inconsistency. There were 31 patients evaluated who suffered from limb weakness with less than 72 hours of evolution, from the emergency department. From the maneuvers found in the literature, 6 were applied and confronted with the neurology department diagnosis. Validates scales were administered for mood disorders screening. From the patients included in the study, 16 were diagnosed with FND, and the remaining patients as organic. There were no significant demographic differences. The specific signs associated with FND (p<0,01) includes: drift without pronation, “Spinal Injuries Center (SIC) Test”, Hoover’s sign and the abductor sign. The presence of, at least 2 positive signs, has proven to improve its specificity without losing sensitivity. The results show that there is a positive correlation between FND and the presence of depressive symptoms as well as acute psychological stressor. In conclusion, 4 of the evaluated maneuvers have shown adequacy to define the etiology of a motor focus. We consider that the results prioritize the physical examination by the specialist during the evaluation of an acute paresis. Also, these findings help in the conformation of a specific profile.