When Nerves Tell a Different Story: Functional Neurological Disorder (FND) After a Minor Hand Injury.

Cureus

Department of Plastic and Reconstructive Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC.

Published: May 2024

AI Article Synopsis

  • * She surprisingly recovered full sensation and function within two hours after the injury, leading to the diagnosis of functional neurological disorder (FND), specifically functional movement disorder (FMD), after thorough neurological tests.
  • * Collaboration among hand surgeons, neurologists, and occupational therapists is key for accurate diagnosis and treatment, and more research is needed to understand FND better, especially in relation to hand trauma management.

Article Abstract

Hand injuries typically present with localized symptoms. However, we report an unusual case of a 32-year-old female who experienced a transient complete loss of sensation and motor function in her entire left nondominant hand after sustaining a minor 1 cm stab wound between the third and fourth metacarpals. Wound exploration under local anesthesia revealed no tendon, vascular, neural, or bony injury. Remarkably, she spontaneously regained full hand sensation and function within 120 minutes of the injury. Extensive neurological evaluation, including magnetic resonance imaging (MRI), electromyography (EMG), nerve conduction studies (NCS), and somatosensory evoked potentials (SSEPs), ruled out organic pathology and supported a diagnosis of functional neurological disorder (FND), specifically functional movement disorder (FMD). Close collaboration between hand surgeons, neurologists, and occupational therapists is essential for accurate diagnosis and appropriate multidisciplinary management. Further research is needed to elucidate the mechanisms underlying FND and optimize evidence-based treatment for FND in the context of hand trauma. The increased awareness of this condition across specialties involved in hand injury management is crucial to facilitate timely diagnosis and avoid unnecessary interventions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11210830PMC
http://dx.doi.org/10.7759/cureus.61218DOI Listing

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