An Updated Round Table Discussion on FND: Diagnosis of FND and New Phenotypes
Aug 3, 2023
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Experts discuss the positive diagnostic approach to Functional Movement Disorder, the evolution of diagnosing Functional Neurological Disorders, complexities of diagnosing FND with chronic pain, and the significance of a team-based approach in managing FND.
FMD is now a positive diagnosis with clear clinical signs, shifting from a diagnosis of exclusion.
Neurologists use specific motor patterns and video EEGs to identify rule-in signs for functional seizures in FMD.
Deep dives
Diagnosis of FMD as a Positive Diagnosis
Functional movement disorder (FMD) is identified as a central nervous system disorder where symptoms are linked to brain dysfunction. It is crucial to emphasize that FMD is a positive diagnosis with clear clinical signs for accurate assessment. This represents a shift from viewing FMD as a diagnosis of exclusion to actively diagnosing it based on specific clinical indicators, aiding neurologists in making more precise diagnoses.
Identifying Rule-in Signs for FMD Diagnosis
Neurologists leverage neurologic examination skills to identify rule-in signs for functional seizures and movement disorders in FMD. Through observations and specific motor patterns, distinct features like asynchronous movements or tremor and treatment can be detected. Utilizing video EEGs and documenting these signs play a pivotal role in enhancing diagnostic accuracy and understanding the unique clinical features of functional seizures.
Addressing Comorbid Symptoms in FMD Treatment
In the treatment of FMD, addressing comorbid symptoms such as pain, fatigue, and psychiatric issues is essential. Patients with FMD often present with a spectrum of symptoms beyond the neurological aspect, including chronic pain and cognitive fog. Acknowledging and treating these associated symptoms alongside FMD can lead to a more comprehensive and effective treatment approach.
In this first episode of our three-part series, Prof. Jon Stone talks with Drs. Selma Aybek, David Perez, and Sarah Lidstone about FND diagnosis and exploring new phenotypes.