Improvement in Symptom Severity, Processing Speed, Gait, Movement, and Visual Acuity in a Patient with Refractory Functional Neurological/ Conversion Disorder

Background: A 28-year-old, male, patient presents with a diagnosis of functional neurological/ conversion disorder. His condition was refractory to cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), antidepressants, and anti-anxiolytics. His symptoms include twitching and spasms of his left hand and legs, balance issues, weakness, and difficulty walking which all have gotten worse within the last year. Grades Symptom Checklist (GSC) severity was 52/162. Trails A was 19.3 seconds, Trails B was 39.4 seconds, and his processing speed was 55 symbols matched correctly in 2 minutes. His Visual Acuity line difference (VA) was 2.0.

Methods: A five-day, multimodal program of receptor based neurological rehabilitation was administered three times per day, one hour per session. Each session consisted of electrical somatosensory stimulation to the third branch of his trigeminal nerve, and his tibial nerve bilaterally, therapeutic exercises, vestibular rehabilitation exercises, and off-vertical axis rotations.

Results: Following conclusion of five days of receptor based treatment there were significant improvements in GS (-86.5%), TA (-13%), TB (-14%), processing speed (+32.7%) and VA (-90%). Gait, movement parameters, weakness, balance difficulties, and gait also normalized.

Conclusion: Short duration, multimodal, intensive programs of receptor based neurological rehabilitation may be a viable method to improve neurological integrity and performance in individuals with a diagnosis of functional neurological/ conversion disorder. The authors suggest further investigation into short duration, multi-modal, intensive approaches to restoring neurological function in individuals suffering from treatment-resistant functional neurological/ conversion disorder.