International journal of stroke : official journal of the International Stroke Society | 2021
EXPRESS: The use of hypnotherapy as treatment for functional stroke: A case series from a single centre in the UK.
Abstract
BACKGROUND\nFunctional Neurological Disorder (FND) is defined by symptoms not explained by the current model of disease and its pathophysiology. It is found in 8.4% of patients presenting as acute stroke. Treatment is difficult and recurrence rates are high. We introduced hypnotherapy as a therapeutic option in addition to standard stroke unit care.\n\n\nMETHODS\nThis is an observational study of successive patients with FND presenting as acute stroke treated with hypnotherapy between 1.04.2014 and 1.02.2018. The diagnosis of FND was confirmed by clinical exam and CT/MRI imaging. Hypnosis was delivered by a hypnotherapy trained stroke physician using imagery for induction. A positive response was defined as a National Institutes of Health Stroke (NIHSS) score reduction to 0 or by ⥠4 points post hypnotherapy. Costs were calculated as therapist time and benefits as reduction in disability/bed days.\n\n\nRESULTS\n68 patients (mean age 36.4 years, 52 (76%) females, mean baseline NIHSS 5.0 (range 1-9)) were included. Two patients (3%) could not be hypnotized. Fifty-eight 58 (85%) responded, 47 (81%) required one treatment session, while 19% needed up to three sessions for symptomatic improvement. No adverse events were observed. Disability (modified Rankin Scale) reduced from a mean of 2.3 to 0.5 resulting in an average cost saving of £1,658 per patient. Most (n=50, 86%) remained well without recurrence at 6 month follow-up.\n\n\nCONCLUSIONS\nIn this case series hypnotherapy was associated with rapid and sustained recovery of symptoms. A prospective randomized controlled study is required to confirm the findings and establish generalizability of the results.