Background Functional Motor Disorders (FMDs) are increasingly recognized in pediatrics, yet prognostic indicators remain poorly characterized. We examined clinical and health-care variables associated with one-year clinical outcomes. Methods This retrospective study included 72 patients aged 9-18 years diagnosed with FMD at two tertiary pediatric hospitals in Italy and the Czech Republic between 2019 and 2023, with at least 6 months of follow-up and two valid Simplified Functional Movement Disorders Rating Scale assessments. Demographic and clinical features, referral history, therapy type and timing, and Simplified Functional Movement Disorders Rating Scale scores were analyzed at baseline, 6, and 12 months. Results Overall, 69.4% were female, and mean symptom-onset age was 13.5 ± 1.99 years. Motor severity improved from baseline (10.25) to 12 months (3.55; P < 0.001), with 43.1% achieving remission. Longer symptom duration was independently associated with higher severity at baseline (β = 1.19, P = 0.021), 6 months (β = 2.07, P < 0.001), and 12 months (β = 1.79, P < 0.001). More prior referrals independently predicted higher 12-month severity (β = 1.00, P = 0.047). Longer time to FMD-directed treatment was associated with higher follow-up severity and a different symptom trajectory (Time × treatment timing: P = 0.007). Trajectories did not consistently differ by sex or symptom phenotype. Conclusions Longer symptom duration, more previous referrals, and delayed treatment were associated with greater one-year motor severity. These findings underscore the prognostic relevance of symptom duration and the potential importance of timely access to care, although prospective studies are needed to establish causality.
Background In September 2023, the Polish Ministry of Health warned that two lots of Sabril (vigabatrin) powder for oral solution and tablets, released in 2021, contained trace amounts of tiapride. Methods and Results We identified three children with tuberous sclerosis complex who presented in the Department of Neurology and Epileptology, Children's Memorial Health Institute with sudden clinical worsening and unexplained symptoms after withdrawal of contaminated vigabatrin lots. The reported adverse effects included increased frequency and severity of seizures, significant behavioral problems, insomnia, weight loss, and secondary amenorrhea. One patient required admission to the intensive care unit due to drug-resistant status epilepticus. Conclusions Our observations suggest that rapid withdrawal of tiapride, even administered in low doses, may result in significant and life-threatening deterioration in patients with epilepsy.
