Abstract

Psychogenic unresponsiveness is a rare manifestation of functional neurological disorder (FND), presenting as apparent loss of consciousness without structural, metabolic, or toxic abnormalities. Its close resemblance to coma and related DOC places it at a challenging diagnostic intersection of neurology, clinical psychology, and psychiatry. We describe a patient with prolonged unresponsiveness who underwent extensive acute neurological evaluation. Unremarkable neuroimaging and electrophysiological studies and preserved brainstem reflexes were inconsistent with true coma. A multidisciplinary assessment ultimately led to the diagnosis of psychogenic unresponsiveness. Our case underscores the diagnostic complexity of psychogenic unresponsiveness and highlights the importance of early recognition to avoid unnecessary interventions and iatrogenic harm. Integrated care across neurology, psychiatry, and clinical psychology is essential for accurate diagnosis and optimal outcomes.

Keywords

functional neurological disorder, FND, Guillain Barre Syndrome (GBS), weakness