Impact of symptoms in patients with functional neurological symptoms on activities of daily living and health related quality of life

When designing a randomised clinical study in patients with functional neurological symptoms (FNS) our problem was what the best primary outcome measure is in this group of patients: activities of daily living (ADL) or quality of life (QoL)? In patients with neurological diseases, ADL is preferred over QoL, but in a pilot study we found that in patients with FNS who improved, the ADL scores hardly changed while there was a clear difference in the QoL scores. Therefore, the primary aim of the present study was to investigate the impact of FNS in patients on ADL and QoL. Patients eligible for this study were referred to the outpatient department or day clinic for neurology at the Academic Medical Center (AMC) in Amsterdam for the first time and with neurological symptoms which could not be explained by neurological disease (FNS group). Patients with the following symptoms were included: at least two locations of pain (consisting of headache, arm-, leg-, back- and/or neck pain), psychogenic movement disorders, pseudo-epilepsy; and sensory- and motor disturbances, mainly sensory symptoms. We excluded patients: under 18 years of age; with a diagnosis of FNS …