Functional symptom

<h2 id="weakness">Weakness</h2>
<p>Functional weakness is weakness of an arm or leg without evidence of damage or a disease of the nervous system. Patients with functional weakness experience symptoms of limb weakness which can be disabling and frightening such as problems walking or a 'heaviness' down one side, dropping things or a feeling that a limb just doesn't feel normal or 'part of them'.  Functional weakness may also be described as <a href="/facts/Functional_neurological_symptom_disorder/QIbptMBD">functional neurological symptom disorder</a> (FNsD), Functional Neurological Disorder (FND) or functional neurological symptoms. If the symptoms are caused by a psychological trigger, it may be diagnosed as 'dissociative motor disorder' or <a href="/facts/Conversion_disorder/WjDo5TJ8">conversion disorder</a> (CD).
</p><p>To the patient and the doctor it often looks as if there has been a <a href="/facts/Stroke/DwpjdzY0">stroke</a> or have symptoms of <a href="/facts/Multiple_sclerosis/vghXl0IQ">multiple sclerosis</a>. However, unlike these conditions, with functional weakness there is no permanent damage to the nervous system which means that it can get better or even go away completely.
</p><p>The diagnosis should usually be made by a consultant <a href="/facts/Neurologist/TXYEMSYI">neurologist</a> so that other neurological causes can be excluded. The diagnosis should be made on the basis of positive features in the history and the examination (such as <a href="/facts/Hoover%2527s_sign_(leg_paresis)/WNq8VQ5a">Hoover's sign</a>).<a class="footnote-ref" id="fnref:7" href="#fn:7"><sup>7</sup></a> It is dangerous to make the diagnosis simply because tests are normal. Neurologists usually diagnose wrongly about 5% of the time (which is the same for many other conditions.)
</p><p>The most effective treatment is <a href="/facts/Physiotherapy/q24XDqHF">physiotherapy</a>, however it is also helpful for patients to understand the diagnosis, and some may find CBT helps them to cope with the emotions associated with being unwell. For those with conversion disorder, psychological therapy is key to their treatment as it is emotional or psychological factors which are causing their symptoms.
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<h3>Giveway weakness</h3>
<p>Giveway weakness (also "give-away weakness", "collapsing weakness", etc.) refers to a symptom where a patient's arm, leg, can initially provide resistance against an examiner's touch, but then suddenly "gives way" and provides no further muscular resistance. It can also be seen if the examinee is not cooperating with the exam and does not produce a full effort. This may sometimes be associated with secondary gain from being injured.
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<h2 id="see-also">See also</h2>
<ul><li><a href="/facts/Functional_disorder/Ren4yDkM">Functional disorder</a></li>
<li><a href="/facts/Functional_neurological_symptom_disorder/QIbptMBD">Functional neurological symptom disorder</a></li>
<li><a href="/facts/Idiopathy/YIVAonwA">Idiopathy</a></li></ul>

<h2 id="further-reading">Further reading</h2>

<ul><li>Howlett S, Grünewald RA, Khan A, Reuber M (September 2007). "Engagement in psychological treatment for functional neurological symptoms—Barriers and solutions". <i>Psychotherapy</i>. 44 (3): 354–60. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1037%2F0033-3204.44.3.354">10.1037/0033-3204.44.3.354</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/22122261">22122261</a>.</li>
<li>Bass C, May S (August 2002). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123833">"Chronic multiple functional somatic symptoms"</a>. <i>BMJ</i>. 325 (7359): 323–6. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1136%2Fbmj.325.7359.323">10.1136/bmj.325.7359.323</a>. <a href="/facts/PMC_(identifier)/dX1zMt71">PMC</a> <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123833">1123833</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/12169511">12169511</a>.</li>
<li>Barratt HS, Kalantzis C, Polymeros D, Forbes A (January 2005). "Functional symptoms in inflammatory bowel disease and their potential influence in misclassification of clinical status". <i>Aliment Pharmacol Ther</i>. 21 (2): 141–7. <a href="/facts/Doi_(identifier)/muM9Etpq">doi</a>:<a href="https://doi.org/10.1111%2Fj.1365-2036.2005.02314.x">10.1111/j.1365-2036.2005.02314.x</a>. <a href="/facts/PMID_(identifier)/JlHAvMHt">PMID</a> <a href="https://pubmed.ncbi.nlm.nih.gov/15679763">15679763</a>.</li></ul>

<h2 id="references">References</h2>

<ol>
<li id="fn:1"><p>"Functional neurologic disorders/conversion disorder — Symptoms and causes". Mayo Clinic. Retrieved 2020-11-10. <a href="https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197" target="_blank">https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></p></li>
<li id="fn:2"><p>Mayou, Richard; Farmer, Andrew (2002-08-03). "Functional somatic symptoms and syndromes". BMJ: British Medical Journal. 325 (7358): 265–8. doi:10.1136/bmj.325.7358.265. PMC 1123778. PMID 12153926. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123778" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123778</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></p></li>
<li id="fn:3"><p>Mayou R, Farmer A (2002). "ABC of psychological medicine: Functional somatic symptoms and syndromes". BMJ. 325 (7358): 265–8. doi:10.1136/bmj.325.7358.265. PMC 1123778. PMID 12153926. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123778" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123778</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></p></li>
<li id="fn:4"><p>Bransfield, Robert C.; Friedman, Kenneth J. (2019-10-08). "Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty". Healthcare. 7 (4): 114. doi:10.3390/healthcare7040114. PMC 6955780. PMID 31597359. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955780" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6955780</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></p></li>
<li id="fn:5"><p>Fee CR, Rutherford WH (March 1988). "A study of the effect of legal settlement on post-concussion symptoms". Arch Emerg Med. 5 (1): 12–7. doi:10.1136/emj.5.1.12. PMC 1285470. PMID 3408521. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285470" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1285470</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></p></li>
<li id="fn:6"><p>Crofford, Leslie J. (2015). "Chronic Pain: Where the Body Meets the Brain". Transactions of the American Clinical and Climatological Association. 126: 167–183. PMC 4530716. PMID 26330672. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4530716</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></p></li>
<li id="fn:7"><p>Sharpe, M.; Zeman, A.; Stone, J. (1 September 2002). "Functional weakness and sensory disturbance". Journal of Neurology, Neurosurgery & Psychiatry. 73 (3): 241–5. doi:10.1136/jnnp.73.3.241. PMC 1738014. PMID 12185152. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738014" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1738014</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></p></li>
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Functional symptom open-in-new

Functional symptom