Neurologic diseases easily misdiagnosed as psychogenic disorders : their pathomechanisms may disclose the mystery of functional neurological disorder (hysteria)

Abstract

Many neurologic diseases, such as myasthenia gravis, multiple sclerosis, autoimmune encephalitis, and several neurodegenerative diseases, have been easily misdiagnosed as psychogenic/functional disorders. Moreover, endocrine diseases, presenting neuropsychiatric symptoms, and unusual movement disorders, such as dyskinesia or catalepsy, are also often misunderstood as psychogenic.

Analyzing these misinterpreted symptoms, I speculate that there are causative factors, such as monoamine (especially dopamine), HPA axis, autoimmune, or autonomic nervous system, which may be common to the mechanism of functional neurologic disorders. Its commonality also has been demonstrated by structural similarities between functional imaging studies in neurologic/endocrine and functional neurological disorders (hysteria). Therefore, it is concluded that functional neurological disorders can have an organic basis.