In this episode I am in conversation with Dr Robert Baloh to explore his insightful perspective of mass psychogenic illness specifically, and functional neurological disorders generally. Our conversation explored the general principles of medically unexplained symptoms and why most people have symptoms but only in some do these progress to become psychosomatic. We delved into the patterns, expectations and cultural beliefs that predispose to psychosomatic problems, highlighting such concepts as the placebo and nocebo effects.

In our exploration of mass psychogenic illness, we reviewed such examples as the Belgian Coca Cola epidemic and Havana syndrome. This discussion looks at the factors that lead to the emergence and spread of mass psychogenic illness. Dr Baloh also outlines the mechanisms driving mass psychogenic illness, and the appropriate approaches to their assessment and management.

Dr Baloh also discusses the history of hysteria with reference to such personalities as neurologist Jean-Martin Charcot and psychoanalysis founder Sigmund Freud. He also reviewed the history of such established disorders as multiple chemical hypersensitivity, myalgic encephalopathy and chronic fatigue syndrome. We discussed the uncertainties about the biology of these disorders, and the general ignorance of the medical fraternity and society at large about their nature.

Dr Baloh is the author of 15 books, over 350 articles in peer-reviewed scientific journals, and over 100 book chapters. He also has an interest in the boundary between neurology and psychology, and in the history of neurology. Among his many honours, Dr Baloh received the Hallpike/Nylen Prize at the Bárány Society Meeting in Prague, Czechoslovakia in 1992 and had an international Dizziness and Balance Symposium in his honor at the 2014 American Academy of Neurology meeting in Philadelphia. His book Clinical Neurophysiology of the Vestibular System written with Vicente Honrubia, is currently in the fourth edition and is the standard in the field.