Perinatal, neurodevelopmental and childhood health factors in patients with functional neurological disorder: a retrospective case-record study in a tertiary neuropsychiatry cohort

Background: Functional neurological disorder (FND) is a complex neuropsychiatric condition. While psychological factors have been widely studied, less is known about the role of perinatal, neurodevelopmental and childhood/adolescent physical health factors. Objective: This retrospective case record review aimed to examine the prevalence of perinatal, neurodevelopmental and childhood/adolescent physical health factors in patients with FND and their associations with FND subtypes. Methods: Clinical records of 282 individuals diagnosed with FND were analysed for perinatal problems, neurodevelopmental problems and childhood/adolescent medical history. Functional symptoms were categorised into seizure, motor, sensory and cognitive subtypes. Results: Perinatal problems (31.9%), neurodevelopmental delays (18.1%) and neurodivergent conditions (19.6%) were frequently reported in this cohort. Additionally, 48.2% had a significant physical illness during childhood or adolescence. Functional seizures were significantly associated with neurodevelopmental delays. Conclusion: Neurodevelopmental and childhood/adolescent physical health problems were frequently identified in this FND cohort and may be relevant to the heterogeneity and complexity of symptom presentation. These findings support considering neurodevelopmental vulnerability as an associated clinical dimension in patients with FND, while not implying or precluding a mechanistic role.