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

Table 2 Comparison between the different patterns of symptom onset and progression in pediatric functional neurological disorder

Pattern	Onset characteristics	Progression	Common triggers	Prognosis
Sudden onset	Abrupt appearance of symptoms. Often after a significant stressor	Symptoms can be severe from the outset. May resolve quickly or persist	Acute psychological stress. Traumatic events	May resolve rapidly with early intervention. Can persist if underlying issues are not addressed
Gradual onset	Symptoms develop slowly over time. Initially mild and subtle	Symptoms progressively worsen. May become more disabling over time	Accumulation of stressors. Unresolved psychological issues	Delayed diagnosis is common. Symptoms may become chronic without treatment
Relapsing-remitting	Fluctuating symptoms. Periods of remission interspersed with exacerbations	Symptoms wax and wane. Exacerbations linked to stress	Fluctuating stress levels. Environmental changes	Requires ongoing management. Stress management can reduce relapses
Persistent chronic	Stable but persistent symptoms. Long-lasting with little fluctuation	Symptoms remain consistent over time. Can lead to significant disability	Long-standing psychological or emotional issues	Challenging to treat. Multidisciplinary approach needed for improvement