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The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK

Sanyal, Ranjan; Raseta, Marko; Natarajan, Indira; Roffe, Christine

The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK Thumbnail


Authors

Ranjan Sanyal

Marko Raseta

Indira Natarajan



Abstract

Background Functional neurological disorder is defined by symptoms not explained by the current model of disease and its pathophysiology. It is found in 8.4% of patients presenting as acute stroke. Treatment is difficult and recurrence rates are high. We introduced hypnotherapy as a therapeutic option in addition to standard stroke unit care. Methods This is an observational study of successive patients with functional neurological disorder presenting as acute stroke treated with hypnotherapy between 1 April 2014 and 1 February 2018. The diagnosis of functional neurological disorder was confirmed by clinical examination and computed tomography/magnetic resonance imaging. Hypnosis was delivered by a hypnotherapy trained stroke physician using imagery for induction. A positive response was defined as a National Institutes of Health Stroke score reduction to 0 or by =4 points posthypnotherapy. Costs were calculated as therapist time and benefits as reduction in disability/bed days. Results Sixty-eight patients (mean age 36.4 years, 52 (76%) females, mean baseline National Institutes of Health Stroke 5.0 (range 1–9)) were included. Two patients (3%) could not be hypnotized. Fifty-eight 58 (85%) responded, 47 (81%) required one treatment session, while 19% needed up to three sessions for symptomatic improvement. No adverse events were observed. Disability (modified Rankin Scale) reduced from a mean of 2.3 to 0.5 resulting in an average cost saving of £1,658 per patient. Most (n = 50, 86%) remained well without recurrence at six-month follow-up. Conclusions In this case series, hypnotherapy was associated with rapid and sustained recovery of symptoms. A prospective randomized controlled study is required to confirm the findings and establish generalizability of the results.

Journal Article Type Article
Acceptance Date Jan 7, 2021
Online Publication Date Feb 2, 2021
Publication Date 2022-01
Publicly Available Date Mar 29, 2024
Journal International Journal of Stroke
Print ISSN 1747-4930
Publisher SAGE Publications
Volume 17
Issue 1
Article Number ARTN 1747493021995590
Pages 59-66
DOI https://doi.org/10.1177/1747493021995590
Keywords Hypnotherapy; functional stroke; cost-effective; safe intervention
Publisher URL https://journals.sagepub.com/doi/10.1177/1747493021995590