Een blik vooruit: casusbespreking van functionele oscillopsie bij een adolescente

Abstract

Looking ahead: case report of functional oscillopsia in an adolescent A conversion disorder or functional neurological disorder (FND) is a rare condition with disturbances in voluntary body functions, sensory or motor, unexplained by any known somatic condition. This case report describes intermittent horizontal oscillopsia with normal neuro-ophthalmic findings in a 14-year-old girl. ‘Oscillopsia’ refers to the perception of unstable vision, i.e. an oscillating image. This is usually caused by a newly acquired eye movement disorder type nystagmus, ocular flutter or myokymia. Clinical examination showed positive symptoms of a conversion disorder. During a pediatric admission with multidisciplinary assessment, the diagnosis of FND was made. A multidisciplinary treatment plan was established, starting with psychoeducation about the diagnosis to arrive at a shared perspective of disease theory. This article aims to demonstrate the need for multidisciplinary collaboration in the diagnostic phase of particular symptom presentations with attention to a functional mechanism. This approach contributes to a more rapid and integrated conclusion and reduces the likelihood of an exclusionary diagnosis. The authors provide some examples for communicating with patients, as this is crucial to achieve shared meaning.