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Review
. 2020 Jul;267(7):2164-2172.
doi: 10.1007/s00415-020-09772-w. Epub 2020 Mar 19.

Management of functional neurological disorder

Gabriela S Gilmour  1 , Glenn Nielsen  2 , Tiago Teodoro  2   3   4 , Mahinda Yogarajah  2 , Jan Adriaan Coebergh  4 , Michael D Dilley  4 , Davide Martino  1 , Mark J Edwards  5
Affiliations
Review

Management of functional neurological disorder

Gabriela S Gilmour et al. J Neurol. 2020 Jul.

Abstract

Functional neurological disorder (FND) is a common cause of persistent and disabling neurological symptoms. These symptoms are varied and include abnormal control of movement, episodes of altered awareness resembling epileptic seizures and abnormal sensation and are often comorbid with chronic pain, fatigue and cognitive symptoms. There is increasing evidence for the role of neurologists in both the assessment and management of FND. The aim of this review is to discuss strategies for the management of FND by focusing on the diagnostic discussion and general principles, as well as specific treatment strategies for various FND symptoms, highlighting the role of the neurologist and proposing a structure for an interdisciplinary FND service.

Keywords: Functional movement disorder; Functional neurological disorder; Functional seizures; Psychogenic movement disorder; Psychogenic nonepileptic seizures.

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Conflict of interest statement

Gabriela Gilmour, Tiago Teodoro, Mahinda Yogarajah, Michael Dilley and Davide Martino declare no conflicts of interest. Glenn Nielsen receives research funding from the National Institute for Health Research (NIHR, UK). Jan Coebergh has received an unrestricted speaker fee from Bial. Mark Edwards has received funding from NIHR and the Medical Research Council, receives royalties from the Oxford University Press, and has received honoraria for educational activities from UCB Pharma, Boeringher Ingelheim and Merz Pharma.

Figures

Fig. 1
Fig. 1
Interdisciplinary FND treatment framework emphasizing a holistic approach to the care of FND patients
See this image and copyright information in PMC

References

    1. Edwards MJ, Bhatia KP. Functional (psychogenic) movement disorders: merging mind and brain. Lancet Neurol. 2012;11:250–260. doi: 10.1016/S1474-4422(11)70310-6. - DOI - PubMed
    1. Stone J. Functional neurological disorders: the neurological assessment as treatment. Pract Neurol. 2016;16:7–17. doi: 10.1136/practneurol-2015-001241. - DOI - PubMed
    1. Věchetová G, Růžička E, Nikolai T, et al. The impact of non-motor symptoms on the health-related quality of life in patients with functional movement disorders. J Psychosom Res. 2018;115:32–37. doi: 10.1016/j.jpsychores.2018.10.001. - DOI - PubMed
    1. Stone J, Edwards MJ. Trick or treat: showing patients with functional (psychogenic) motor symptoms their physical signs. Neurology. 2013;79:282–284. doi: 10.1212/WNL.0b013e31825fdf63. - DOI - PubMed
    1. Ludwig L, Pasman JA, Nicholson T, et al. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case–control studies. Lancet Psychiatry. 2018;5:307–320. doi: 10.1016/S2215-0366(18)30051-8. - DOI - PubMed

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