42 Multi-agent allergies as predictor of functional neurological disorder

Objectives/Aims Functional neurological disorders (FND) account for 20% of patients in neurology clinics and can lead to functional impairment, multiple re-attendances and significant cost. However, diagnosing FND remains challenging; identifying associated factors could aid earlier diagnosis. We aimed to determine the value of self-reported multi-allergies as predictor for FND. Methods We retrospectively reviewed records of consecutive patients from two clinics (General Neurology and FND), St George’s Hospital, January 2015–June 2018. A logistic regression model was used in conditional fashion; statistically significant variables in univariate analysis were included. Results Of 720 patients with definitive diagnosis, 243 (33.8%) had FND and 477 (66.3%) another neurological disorder. Mean age was 43 years (range 16–93), 63.9% (453) were female. 81 patients with FND (33%) had Non-epileptic attack disorder (NEAD). In multivariate analysis, factors associated with FND were female sex (Odds Ratio [95% Confidence Intervals], OR=0.49 [0.33, 0.73], p Increased number of allergies increased the probability of FND: one allergy OR=4.53 [3.08, 6.65, p Conclusions Previous studies highlighted the increased prevalence of allergies in NEAD compared to epilepsy. Our study expand this to all FND, as only 1 in 3 FND patients had NEAD. Presence of allergies, particularly to multiple agents, should raise the suspicion of FND.