Close your eyes and see - stroke sequelae versus functional neurological disorder in a physician

The first author was a left-handed, 51-year-old nephrologist who experienced a neurologic event. She underwent neurosurgery complicated by hemorrhage. Post-operatively, she developed persistent vertigo and unilateral tongue pain which persisted for over five years. Early neuroimaging revealed expected encephalomalacia but no neuroanatomical basis for my symptoms. A functional neurological disorder was suspected, and she was seen by several psychiatrists and psychotherapists. However, she suspected a neuroanatomical lesion would better explain her unrelenting symptoms. After seeing many neurologists, a neuroanatomical diagnosis was finally made. The theory and practice of medicine mandates that subjective complaint guide the modality and interpretation of objective evidence. The final neurologist knew where on neuroimaging to look because she was guided by my complaints - vertigo and unilateral tongue pain. In her case, detailed scrutiny of neuroimaging by a neurologist, after encephalomalacia and gliosis were fully completed, gave a more accurate neuroanatomical diagnosis and a more realistic prognosis.

Automated summary

The first author, a 51-year-old left-handed nephrologist, experienced a neurologic event and underwent neurosurgery complicated by hemorrhage. She developed persistent vertigo and unilateral tongue pain for over five years. Despite initial neuroimaging showing encephalomalacia and no neuroanatomical basis for her symptoms, she suspected a neuroanatomical lesion and finally received a neuroanatomical diagnosis after seeing many neurologists.