Suggestibility in functional neurological disorders

From the simple message of ‘I will please’ (Latin placēbō ) encapsulated in a sugar pill, to the famous theatrics of Jean-Martin Charcot’s hypnotic seizure inductions and treatments (figure 1), implicit and explicit narratives of healing and illness have been noted to exert a particularly strong influence on functional neurological disorder (FND). Although the placebo effect is near universal in medicine, and cultural frameworks are relevant for any illness experience, expectancy plays a more central mechanistic role in FND.1 Techniques of suggestion are still occasionally used in neurology practice, specifically to diagnose functional motor deficits by demonstrating reversibility,2 or to provoke dissociative seizures during video electroencephalography monitoring to enable a definitive diagnosis.3 Figure 1 The painting ‘Une lecon clinique a la Salpetriere’ (1887) by Andre Brouillet depicts Jean-Martin Charcot inducing neurological symptoms through hypnotic suggestion. His student Joseph Babinski (pictured holding the patient) later proposed changing the term hysteria to pithiathism (from Ancient Greek peithō , meaning ‘I convince’ ), emphasising the suggestibility of symptoms as a cardinal feature. Source: …