Background Functional neurological disorder (FND) is characterised by neurological symptoms, such as seizures and abnormal movements. Despite its significance to patients, the clinical features of chronic pain in people with FND, and of FND in people with chronic pain, have not been comprehensively studied. Methods We systematically reviewed PubMed, Embase and PsycINFO for studies of chronic pain in adults with FND and FND in patients with chronic pain. We described the proportions of patients reporting pain, pain rating and timing, pain-related diagnoses and responsiveness to treatment. We performed random effects meta-analyses of the proportions of patients with FND who reported pain or were diagnosed with pain-related disorders. Results Seven hundred and fifteen articles were screened and 64 were included in the analysis. Eight case–control studies of 3476 patients described pain symptoms in a higher proportion of patients with FND than controls with other neurological disorders. A random effects model of 30 cohorts found that an estimated 55% (95% CI 46% to 64%) of 4272 patients with FND reported pain. Random effects models estimated diagnoses of complex regional pain syndrome in 22% (95% CI 6% to 39%) of patients, irritable bowel syndrome in 16% (95% CI 9% to 24%) and fibromyalgia in 10% (95% CI 8% to 13%). Five studies of FND diagnoses among 361 patients with chronic pain were identified. Most interventions for FND did not ameliorate pain, even when other symptoms improved. Conclusions Pain symptoms and pain-related diagnoses are common in FND. Classification systems and treatments should routinely consider pain as a comorbidity in patients with FND. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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疼痛和功能性神经障碍：系统评价和荟萃分析

背景 功能性神经系统疾病 (FND) 的特点是神经系统症状，例如癫痫发作和异常运动。尽管对患者很重要，但 FND 患者的慢性疼痛以及慢性疼痛患者的 FND 的临床特征尚未得到全面研究。方法 我们系统地回顾了 PubMed、Embase 和 PsycINFO 对成人 FND 慢性疼痛以及 FND 慢性疼痛患者的研究。我们描述了报告疼痛的患者比例、疼痛等级和时间、疼痛相关诊断以及对治疗的反应。我们对报告疼痛或被诊断患有疼痛相关疾病的 FND 患者比例进行了随机效应荟萃分析。结果筛选文献715篇，纳入分析64篇。8 项针对 3476 名患者的病例对照研究描述了 FND 患者中疼痛症状的比例高于患有其他神经系统疾病的对照患者。30 个队列的随机效应模型发现，4272 名 FND 患者中估计有 55%（95% CI 46% 至 64%）报告有疼痛。随机效应模型估计 22%（95% CI 6% 至 39%）的患者诊断为复杂区域疼痛综合征，16%（95% CI 9% 至 24%）患者诊断为肠易激综合征，10%（95% CI 95%）患者诊断为纤维肌痛CI 8% 至 13%）。确定了 5 项对 361 名慢性疼痛患者进行 FND 诊断的研究。大多数 FND 干预措施并不能减轻疼痛，即使其他症状有所改善。结论 疼痛症状和疼痛相关诊断在 FND 中很常见。分类系统和治疗应常规将疼痛视为 FND 患者的合并症。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。