Browse categories and answer follow-up questions to refine your symptom profile.
Immediate safety and stabilization
Stabilization priorities
Airway compromise
Stridor
Inability to protect airway
Breathing compromise
Hypoxemia
Hypercapnia
Circulatory compromise
Hypotension
Shock physiology
Glucose
Hypoglycemia
Hyperglycemia
If seizure-like activity and convulsive status epilepticus not excluded, follow status epilepticus pathway
ACEP seizure clinical policy Level A treatment escalation after appropriately dosed benzodiazepines
Avoid iatrogenic escalation when functional seizure features strongly supported
Time-critical exclusions
Cannot-miss mimics
Acute ischemic stroke
Last known well time
Persistent focal deficit pattern
Intracranial hemorrhage
Thunderclap headache
Anticoagulant use
CNS infection
Fever
Neck stiffness
Spinal cord compression
Saddle anesthesia
Urinary retention
Convulsive status epilepticus
Continuous convulsions 5 minutes or longer
Recurrent convulsions without recovery
Toxicologic syndrome
Sympathomimetic toxidrome
Anticholinergic toxidrome
Key concepts
Functional neurological symptom disorder
DSM-5 framework based on positive clinical features and incompatibility with recognized neurological disease
Symptoms not intentionally produced
Distinct from malingering
Distinct from factitious disorder
Functional seizures
VEEG gold standard for documented diagnosis
Benzodiazepines and antiseizure medications lack evidence of benefit for functional seizures without epilepsy
Communication and environment
Therapeutic stance
Respectful language
Avoid stigmatizing behavior
Avoid implying symptoms are fabricated
Calm low-stimulation setting
Reduce crowding
Reduce repeated provocative exams
Early framing
Symptoms real and common
Brain network functioning problem
Treatable condition
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.