Functional Neurological Disorders

Question 1

What is the definition of functional neurological disorder?

Answer 1

Change in function rather than structure of a system - blackouts, paralysis, abnormal movements
Symptoms are not explained by a neurological disease

Question 2

What is included in the history of functional neurological disease?

Answer 2

Ask about disability
Onset and course
Dissociative symptoms
Illness beliefs
Social impacts
Get old notes

Question 3

What is included in the examination of function neurological disease?

Answer 3

Inconsistency, positive functional signs, absence of signs of disease, eye movements (convergence spasm), tremor disappears when distracted, paralysis, fixed dystonia

Question 4

What signs can show functional weakness?

Answer 4

Hoover’s sign - hip extension is weak when tested directly but normal hip extension when asked to flex oppisite hip
Abductor sign
Functional sensory disturbance also checked

Question 5

What investigations are used in FND?

Answer 5

MRI brain scan
Negative Video EEG
Functional MRI

Question 6

What is the management for FND?

Answer 6

Explain what they have
Self help is key to recovery
Depression/ anxiety - antidepressants

Question 7

What healthcare teams are involved in management for FND?

Answer 7

Neurologist, therapist, psychology, physio/ occupational/ speech therapy, rehab medicine and chronic pain services