FND and Brain Tumour - Patient 1

This 55 year old patient is, since five years ago, being followed in the neurosurgery department of the University Hosital Centre in Rouen for a non-evolutionary low-grade oligodendroglioma of the left temporal region, discovered during headaches and which had nothing to do with the lesion (see Image 1). Following a routine MRI control, she felt a particular kind of heat in the throat. This was immediately followed by major language and writing problems.

Image 1

The symptoms began fifteen days before this consultation. She therefore has great difficulty finding her words (see video 1) and her writing is very awkward and irregular (see video 2). The hypothesis of functional neurological disorders is evoked by the brutality of the onset of symptoms, while the tumor is manifestly non-evolutionary and a new MRI control is again normal.


Video 1


Video 2

Magnetic stimulation will consist of a single series of 60 shocks on the vertex at 1 Hz. All symptoms will immediately disappear. She will once again be able to speak normally (see video 3) and her writing will be completely normalised (image 2). There will be no relapse.

Around a tumoural lesion, there can be a fragility of connectivity that might have decompensated on the occasion of stress related to the passing of the MRI and maybe of the peculiar sensation in the throat. With this patient, immediate improvement after fifteen days of evolution and after a single session of large field transcranial magnetic stimulation is a very strong argument to confirm the functional origin of the symptoms. There is a correlation between the symptoms types and the topography of the lesion (left temporal in a right handed person). The brutal onset of disorders on a pathology, in priority non-evolutionary, is another argument in favour of a functional pathology.