Analysis of clinical characteristics and prognosis of childhood functional neurological disorder: Identifying key factors of prognosis and optimizing clinical management

Background: To explore and analyze the clinical characteristics of childhood functional neurological disorder (FND) and identify key factors influencing the prognosis to optimize clinical practice. Method: In this retrospective study, clinical data of children with FND who visited the Department of Pediatric Neurology of West China Second Hospital of Sichuan University between March 2020 and March 2023 were collected to analyze their clinical characteristics and prognosis. And 173 patients completed follow-up one year after diagnosis. Logistic regression was used to analyze factors associated with clinical prognosis. Results: Among the 248 patients, with a median age of 10 years (IQR 9-12), 60.5 % were male and 39.5 % were female. The most common symptoms were weakness or paralysis and non-epileptic seizures. 11.2 % combined with psychiatric disorders. Half of the patients had experienced previous stressors, including personal (40.3 %), family (22.6 %), and school factors (21.0 %). The average follow-up time was 488.7 +/- 295.5 days. The overall prognosis was good, with clinical symptom remission in 75.1 % of cases. Logistic regression revealed that both the duration of symptoms and comorbid psychiatric disorders were negatively associated with a good prognosis. Conclusion: The clinical characteristics of children with FND may be associated with socio-cultural background factors and psychological factors. Symptom duration and comorbid psychiatric disorders are important factors influencing prognosis.