Post-operative functional neurological symptom disorder after anesthesia

All patients are vulnerable during the immediate post-anesthetic recovery period. The occurrence of functional neurological symptom disorder (FNSD) is a rare manifestation during this period.

FNSD includes neurological symptoms that are not consistently explained by neurological or medical conditions. This diagnosis should be considered after excluding life-threatening causes and when physical exam signs are inconsistent with an organic cause.

The group of researchers from the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, U.S., described the largest case series to date consisting of six patients who developed FNSD in the immediate post-anesthetic period. Additionally, they performed a systematic review of the literature to identify published reports of post-anesthetic FNSD in their paper published in BJBMS.

This data may contribute to the presentation, risk factors, management, and treatment outcomes of post-operative FNSD in the context of anesthetic administration, and may also facilitate the stratification of patients who are at high risk for experiencing these episodes.

Potential risk factors of FNSD include female sex, history of prior FNSD spell, psychiatric illness and general anesthesia. While no deaths were experienced in patients experiencing post-anesthetic FNSD, many had unanticipated admission to the hospital (53%) or to the intensive care unit (25%).

Prompt diagnosis and management of this condition may prevent unnecessary diagnostics, invasive procedures and their associated potential complications, and hospital cost.