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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 64343
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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there. Having coped with the vagaries of Relapsing-Remitting

Resolved Question:

Hello there. Having coped with the vagaries of Relapsing-Remitting MS for 27 years, including further Academic Degrees and career shifts more towards research and lecturing, I now find myself in the invidious position of having been 'diagnosed' as having MS + 'Functional Neurology'.
I now feel as if I have been labelled, and feel, to a degree, like a fraud.
My MRI results, whilst documented from zero plaques to multiple (t-weighted and plain), no longer fit with updated diagnostic protocols.
My objective signs remain, as they admitted; but no treatment will be sanctioned because of this re-categorisation.
I am deeply upset by this, and feel badly let down by the UK 'system'. Can you please shed any light on this?
53yr old female:
Dr Linda Bates (MD/PhD) (Former Columbia Univ. + NYSPI Researcher)
Submitted: 2 years ago.
Category: Medical
Expert:  DrRussMD replied 2 years ago.
Hello
Impossible to say without further information.
Multiple plaques over time would go along with MS.
One can not call this functional.
Any other details?
Customer: replied 2 years ago.

It is said that although I am clearly, objectively disabled (e.g. advanced optic neuritis, abnormal reflexes, ataxia, tremor and induced abnormal fatigue), the 'pattern and severity of plaques do not correspond with reported and displayed disability.) .

All of this whilst hospitalised, using ISC to manage a dystonic bladder 'swing' from incontinence.

Mobility aids (prescribed) range from 1 or 2 crutches, Delta walking frame or on occasion, wheelchair.

Thank you for your time and attention. Dr B

Expert:  DrRussMD replied 2 years ago.
OK
I understand.
So what is your exact question about this.
Customer: replied 2 years ago.

In short, do you feel that use of the term 'functional neurology' is appropriate, and if so - what exactly is the meaning and ramifications of this tag. Doesn't it imply psychological primary/secondary gain?

I feel as if I have been degraded in some way.

My own expertise, and the opinion of my GP remain as a clear MS diagnosis - to be supported appropriately. I would just value an other objective opinion.

Expert:  DrRussMD replied 2 years ago.
Functional neurology is not a term applying to any condition.
If you mean functional neuropathy, this is perhaps a medical condition but is vague, and is not appropriate if there are documented MS plaques.
So my answer given the current information is no, not appropriate.
That said, I can not examine you, I don't have a medical chart, I am not a consulting doctor, so I do not have all of the details. But, based on your information here, my answer is no.
OK, so that is an initial answer….
Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 2 years ago.

Thank you for that. I have been as open and honest as it is possible to be.

1). As I did my PhD in Neuroscience and Biopsychology, as a Clinician, I view the term 'functional', in this instance, as suggesting a psychological gain aspect.

2) This is distinguished from, e.g., secondary functional increased muscle tone in association with a fracture.

3) Finally - have you ever felt a need to assign such a tag to your, or your colleagues MS patients?

Expert:  DrRussMD replied 2 years ago.
No I have not.
Functional medicine is a term, more precisely, that defines illness as the result of disease mediators, in the case of MS, a derangement of the immune system.
Of course, this would having nothing to do with changing the diagnoses or the assessment as to the degree of disability.
please click a positive rating [hopefully excellent]. If you forgot something, come back. I am here daily.
Customer: replied 2 years ago.

Thank you for your time and expertise. You have set my mind at rest, and reassured me that none of my symptoms have been 'psychologically generated'.

I will be happy to leave an excellent review, releasing payment.

I also thank you for your professional courtesy.

Dr Linda Bates (Linda)

Expert:  DrRussMD replied 2 years ago.
You are welcome anytime.
Any questions.
I am in medical daily.
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