Resumen
Introducción: los trastornos neurológicos funcionales son un motivo de consulta frecuente en la práctica clínica y una causa importante de discapacidad y costos.
Materiales y métodos: artículo de revisión narrativa que sintetiza las últimas dos décadas en investigación clínica en esta área.
Resultados: se describe un diverso grupo de síntomas motores, sensitivos, cognitivos, visuales y eventos paroxísticos en los que no hay lesión estructural del sistema nervioso, así como tampoco una enfermedad neurológica conocida. En su génesis interactúan factores biológicos, neuronales y ambientales con los mecanismos cognitivos, emocionales y conductuales que se originan en experiencias de vida adversas o aprendizaje desadaptativo.
Discusión: el diagnóstico de estas condiciones no se hace por exclusión, sino que se sustenta en un abordaje clínico basado en la presencia de datos a la anamnesis y signos positivos al examen físico. El manejo de estos va desde la primera consulta, la comunicación del diagnóstico, el establecimiento de confianza con el paciente y el uso de recursos terapéuticos como la psicoterapia, la terapia física y la ocupacional.
Conclusiones: a lo largo de esta revisión, se brindan las herramientas para entender los trastornos neurológicos funcionales, desde su fisiopatología y hasta el diagnóstico y el tratamiento.
Citas
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