Improvement of functional paralysis following unexpected comatose states

Instances of recovery from a functional neurological disorder (FND) can shine a light on the nature of the condition and its potential treatment. Unexpected recovery of FND symptoms can occur after a comatose state or an anaesthetic, or after various other scenarios. Two illustrative cases exemplify the phenomenon. A 59-year-old man had an 8-year history of functional paraparesis that had developed subacutely following a car crash. The paralysis recovered dramatically after an episode of medically induced coma, administered because of SARS-CoV-2 acute respiratory distress. A 40-year-old woman had complete recovery of FND-related arm paralysis and associated chronic pain after a deliberate overdose that led to a comatose state necessitating a brief period of ventilation. We compare these with similar recoveries in other scenarios, such as following hypnosis or extreme external stress. We discuss the potential mechanisms for recovery and the implications for FND treatment.