Functional Neurological Disorders

Question 1

what is a functional neurological disorder?

Answer 1

a change in function rather than structure of a system and the symptoms are not explained by a neurological disease

Question 2

what do we want to ask about the history of someone with FND?

Answer 2

symptoms, disability, onset and course, social effects, history of abuse

Question 3

what do we look for in examination of someone with a functional neurological disorder?

Answer 3

inconsistency will be found= different days have different findings, postive functional signs, absence of signs of disease, convergence eye spasm, tremor (dissappears with distraction), paralysis, ‘give way weakness’

Question 4

what are signs of functional weakness ?

Answer 4

hoover’s sign= hip extension is weak hen tested directly and normal when patient is asked to flex the opposite hip and the abductor sign

Question 5

what would be the sensory disturbance of a functional neurological disorder be?

Answer 5

hemisensory disturbance= split down the midline

Question 6

what investigations would we do for a suspected functional neurological disorder?

Answer 6

MRI brain scan, negative video EEG (show seizure is not epileptic), functional MRI (different activation pathway)- investigation used to rule out other disorders

Question 7

how are functional neurological disorder managed?

Answer 7

explain what they do and dont have, explain that you believe them and what they have, potential to get better and self-help is key to recovery- hardware and software analogy

Question 8

how else can FND be treated?

Answer 8

some patients will need some more therapy eg psychiatry, physical rehabilitation and support organisations and information is available for patient and family

Question 9

do symptoms of FND ever improve?

Answer 9

symptoms can go away but come back at different stages in life and some will improve but not have full recovery but full recovery also possible- it can be triggered by certain things or be random