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

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.

Citation

Sanyal, R., Raseta, M., Natarajan, I., & Roffe, C. (2022). The use of hypnotherapy as treatment for functional stroke: A case series from a single center in the UK. International Journal of Stroke, 17(1), 59-66. https://doi.org/10.1177/1747493021995590

• Journal Article Type: Article
• Acceptance Date: Jan 7, 2021
• Online Publication Date: Feb 2, 2021
• Publication Date: 2022-01
• Publicly Available Date: May 30, 2023
• 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