Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Sep 9, 2025; 14(3): 105290
Published online Sep 9, 2025. doi: 10.5409/wjcp.v14.i3.105290
Unraveling functional neurological disorder in pediatric populations: A systematic review of diagnosis, treatment, and outcomes
Mohammed Al-Beltagi, Nermin Kamal Saeed, Adel Salah Bediwy, Eman A Bediwy, Reem Elbeltagi
Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Pediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, ‎Governmental Hospitals, Manama 12, Bahrain
Nermin Kamal Saeed, Medical Microbiology Section, Department of Pathology, Royal College of Surgeons in Ireland–Bahrain, Busaiteen 15503, Muharraq, Bahrain
Adel Salah Bediwy, Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
Adel Salah Bediwy, Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Eman A Bediwy, Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Algharbia, Egypt
Reem Elbeltagi, Department of Mediciene, Royal College of Surgeons in Ireland – Medical University of Bahrain, Busaiteen 15503, Muharraq, Bahrain
Co-first authors: Mohammed Al-Beltagi and Nermin Kamal Saeed.
Author contributions: Al-Beltagi M conceptualized the study, designed the systematic review framework, and coordinated the manuscript writing and revisions; Saeed NK contributed to the literature search, data extraction, and critical revision of the methodology and discussion; Bediwy AS assisted in analyzing the included studies and refining the results section; Bediwy EA contributed to data synthesis, reference management, and manuscript formatting; Elbeltagi R assisted in reviewing and editing the final draft for clarity and coherence. All authors reviewed and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest related to this study. No financial, personal, or professional relationships influenced the content or conclusions of this manuscript.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mohammed Al-Beltagi, MD, PhD, Chief Physician, Professor, Department of Pediatrics, Faculty of Medicine, Tanta University, 1 Hassan Radwan Street, Tanta 31511, Alghrabia, Egypt. mbelrem@hotmail.com
Received: January 17, 2025
Revised: March 14, 2025
Accepted: April 7, 2025
Published online: September 9, 2025
Processing time: 150 Days and 15.8 Hours
Abstract
BACKGROUND

Functional neurological disorder (FND) in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology. Despite its prevalence, FND in pediatric populations remains under-researched, with challenges in diagnosis and management

AIM

To synthesize the current literature on FND in children, focusing on clinical presentation, diagnostic approaches, treatment strategies, and outcomes.

METHODS

A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Web of Science, for articles published up to August 2024. Studies were included if they addressed FND in pediatric populations, specifically focusing on review articles, research articles, systematic reviews, meta-analyses, case reports, guidelines, expert opinions, and editorials. Data extraction and quality assessment were performed according to PRISMA guidelines. A total of 308 articles were included in the final analysis.

RESULTS

The analysis included 189 review articles, 57 research articles, 3 systematic reviews and meta-analyses, 5 case reports, 2 guidelines, 5 expert opinions, and 2 editorials. Key findings revealed a broad spectrum of symptoms, including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND. Diagnostic challenges were frequently highlighted, emphasizing the need for interdisciplinary approaches. Treatment strategies varied, with cognitive-behavioral therapy (CBT) and multidisciplinary care emerging as the most effective approaches. The outcomes varied, with early intervention being critical for a better prognosis.

CONCLUSION

Early diagnosis and multidisciplinary care, including CBT, are critical for improving outcomes in pediatric FND. Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.

Keywords: Functional neurological disorder; Children; Pediatric neurology; Conversion disorder; Psychogenic disorders; Cognitive-behavioral therapy; Multidisciplinary care; Diagnosis; Treatment outcomes

Core Tip: Functional neurological disorder (FND) in children presents unique diagnostic and therapeutic challenges due to its diverse symptomatology and the absence of organic pathology. Early diagnosis, often hindered by symptom variability, is crucial for effective intervention. Multidisciplinary management, including cognitive-behavioral therapy and comprehensive care involving neurologists, psychiatrists, and psychologists, has shown promise in improving outcomes. However, there is a need for standardized diagnostic criteria and treatment protocols to better guide clinical practice. This systematic review underscores the importance of timely and coordinated care to enhance the prognosis for pediatric patients with FND.