Positive clinical signs in neurological diseases – An observational study

Orwa Aboud, Ayman Al-Salaimeh, Sunil Kumar Raina, Kinshuk Sahaya, Archana Hinduja

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Many patients with organic neurological disease have symptoms and signs that are unexplained by their disease condition. We attempted to explore the prevalence of positive clinical signs in patients with various organic neurological diseases. We performed a prospective uncontrolled observational study on the presence of 7 positive signs in adults with various organic neurological diseases that were admitted to our tertiary care hospital. This observation was performed during their neurological examination in those who provided consent, could comprehend and lacked terminal illness or profound weakness that limited their ability to perform these tasks. We dichotomized them into two groups based on the presence of these signs. Out of 190 patients that were evaluated between 2014 and 2015, 37 patients had at least one positive sign. On univariate analysis: young age, female gender, prior anxiety, history of childhood abuse, identification of sensory deficits on examination and lack of imaging correlation with clinical localization were identified as risk factors for these positive signs. On multivariate analysis, anxiety (OR 2.88, 95% CI 1.11–7.49, p = 0.03) and presence of sensory deficits on examination (OR 5.81, 95% CI 2.36–14.32, p ≤ 0.001) were associated with these positive signs. Positive signs are common in patients with organic neurological diseases that have anxiety or sensory deficits and may imply a component of functional overlay. Large studies are required to understand its pathophysiology and impact on future outcomes.

Original languageEnglish
Pages (from-to)141-145
Number of pages5
JournalJournal of Clinical Neuroscience
Volume59
DOIs
StatePublished - Jan 2019

Keywords

  • Clinical signs
  • Functional neurological disorder
  • Organic neurological disease
  • Positive signs

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology
  • Physiology (medical)

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