Functional Neurological Disorder Might Be Triggered by Getting Vaccinated
Videos purporting to show serious neurological effects from the COVID-19 vaccine have been circulating on social media. While nothing has been substantiated, a viewpoint article from Harvard neurologists suggest the issue might be functional neurological disorder, which is not a direct result of toxic vaccine effects but is a brain-based disorder involving both neurology and psychiatry. Find out more about the condition and why it should not raise fears about the vaccines.
BOSTON – Pharmacists providing COVID-19 vaccines field a lot of questions about side effects. Recently, questions have increased about neurologic adverse events because of dissemination of unsubstantiated videos on social media.
A Viewpoint article in JAMA Neurology provides some information about a possible condition being seen in some cases, cautioning that no link between the condition and COVID-19 vaccines has been substantiated.
Researchers from Harvard Medical School and Massachusetts General Hospital emphasize that the vaccines have been found to be highly effective and safe, with adverse effects including transient symptoms such as fever/chills, headache, fatigue, myalgia/arthralgia, lymphadenopathy, nausea, or local effects of swelling, erythema, or pain.
“With the public being vaccinated, there have recently been videos circulating on social media about major neurologic adverse events after administration of the COVID-19 vaccine,” the authors write. “A few of these videos have been viewed millions of times by the public. Some depict individuals with continuous movements of the trunk and limbs or walking difficulties.”
The Viewpoint notes that pharmacists and other healthcare professionals can make sure that accurate information is provided. “The spread of these videos has fueled vaccine hesitancy concerns and without effective communication by medical professionals to the public, this can lead to reduced vaccination rates and an unnecessary prolongation of the pandemic,” according to the article.
The authors point out that the videos are unproven, and it is not definitively known if the COVID-19 vaccine was administered in the cases depicted. However, they add, “it was reported in the news that at least one patient was told by their physician that the diagnosis was conversion disorder, also known as functional neurological disorder (FND). Here, we provide context regarding potential associations between FND and COVID-19 vaccinations, as effective communication regarding this intersection is critically important.”
The study notes that the Functional Neurological Disorder Society has issued a statement that features in the unsubstantiated videos appear to be consistent with FND, which is among the most common conditions encountered in the outpatient neurology setting.
According to the article, FND is a brain-based disorder “at the intersection of neurology and psychiatry whereby patients develop a range of neurological symptoms precipitated and perpetuated by biological, psychological, and/or environmental factors.” It can be triggered by physical and/or emotionally events, including head injury, medical/surgical procedures, and vaccinations.
“These precipitating factors, while proximal to the development of the symptoms, are not directly caused by the substances in the vaccine in the same manner that, for example, Neisseria meningitidis is the cause of meningitis,” the authors explain. “Instead, factors such as expectations, beliefs, heightened bodily attention, arousal, and threat/emotional processing play important mechanistic roles in the pathophysiology of FND.”
One theory is that abnormal expectations or beliefs can interact with sensorimotor perceptions to provide in part the mechanistic equation for functional neurological symptoms, they point out, adding, “In precipitating physical events, including vaccinations, it is the attention drawn toward the body that is the important biological process, rather than direct neurotoxic or immune-mediated processes. Additionally, vaccines can produce nociceptive experiences, such as local injection site reactions or systemic myalgias, and these unpleasant sensations can promote the redirection of attention toward the body.”
The article states that FND is distinct from feigning, such as malingering and factitious disorder, because patients with functional movements perceive their symptoms as involuntary.
Diagnosis is based on physical examination signs and semiological features, while treatment includes education on the diagnosis, physical rehabilitation, and cognitive behavioral therapy.
As to FND and its possible relationship with COVID-19 vaccinations, the authors argue, “As concern grows, there is a need for health care officials to directly educate the public regarding this issue. A lack of direct messaging may be falsely perceived by the public that the Centers for Disease Control and Prevention is not properly surveilling adverse symptoms or, even worse, concealing them. These patients may feel unheard or ignored, and that can raise more distrust with health care officials.”
They go on to state, “As neurologists, and health care professionals more broadly, we must explain transparently and nonjudgmentally the nature of FND, including that these symptoms are real but not the direct result of toxic vaccine effects. They can theoretically happen with a trigger such as injecting saline, and these events do not mean the current vaccines are unsafe.”