Complex regional pain syndrome and functional neurological disorders: time for reconciliation

Stoyan Popkirov, Ingrid Hoeritzauer, Lesley Colvin, Alan J. Carson, Jon Stone (Lead / Corresponding author)

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)
681 Downloads (Pure)

Abstract

There have been many articles highlighting differences and similarities between complex regional pain syndrome (CRPS) and functional neurological disorders (FND) but until now the discussions have often been adversarial with an erroneous focus on malingering and a view of FND as 'all in the mind'. However, understanding of the nature, frequency and treatment of FND has changed dramatically in the last 10-15 years. FND is no longer assumed to be only the result of 'conversion' of psychological conflict but is understood as a complex interplay between physiological stimulus, expectation, learning and attention mediated through a Bayesian framework, with biopsychosocial predisposing, triggering and perpetuating inputs. Building on this new 'whole brain' perspective of FND, we reframe the debate about the 'psychological versus physical' basis of CRPS. We recognise how CRPS research may inform mechanistic understanding of FND and conversely, how advances in FND, especially treatment, have implications for improving understanding and management of CRPS.

Original languageEnglish
Pages (from-to)608-614
Number of pages7
JournalJournal of Neurology, Neurosurgery and Psychiatry
Volume90
Issue number5
Early online date24 Oct 2018
DOIs
Publication statusPublished - May 2019

Keywords

  • complex regional pain syndrome
  • conversion disorder
  • functional neurological disorder
  • psychogenic
  • reflex sympathetic dystrophy

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