Unraveling functional neurological disorder in pediatric populations: A systematic review of diagnosis, treatment, and outcomes.

Background: Functional neurological disorder (FND) in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology. Despite its prevalence, FND in pediatric populations remains under-researched, with challenges in diagnosis and management.

Aim: To synthesize the current literature on FND in children, focusing on clinical presentation, diagnostic approaches, treatment strategies, and outcomes.

Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, for articles published up to August 2024. Studies were included if they addressed FND in pediatric populations, specifically focusing on review articles, research articles, systematic reviews, meta-analyses, case reports, guidelines, expert opinions, and editorials. Data extraction and quality assessment were performed according to PRISMA guidelines. A total of 308 articles were included in the final analysis.

Results: The analysis included 189 review articles, 57 research articles, 3 systematic reviews and meta-analyses, 5 case reports, 2 guidelines, 5 expert opinions, and 2 editorials. Key findings revealed a broad spectrum of symptoms, including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND. Diagnostic challenges were frequently highlighted, emphasizing the need for interdisciplinary approaches. Treatment strategies varied, with cognitive-behavioral therapy (CBT) and multidisciplinary care emerging as the most effective approaches. The outcomes varied, with early intervention being critical for a better prognosis.

Conclusion: Early diagnosis and multidisciplinary care, including CBT, are critical for improving outcomes in pediatric FND. Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.