Pre PACES Podcast #60 Functional Neurology
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May 7, 2023 Dr. Beth Mallam, a consultant neurologist at Southmead Hospital in Bristol, shares her expertise on functional neurological disorders (FND). She clarifies that FND symptoms occur without structural damage and discusses the complexities of diagnosing them. Beth highlights the importance of recognizing distinguishing features between functional and organic seizures, the variability in symptoms, and the necessity for an empathetic approach when explaining FND to patients. Treatment focuses on tailored therapies and reassurance, rather than medications.
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FND Is A Functional, Not Structural, Disorder
- Functional neurological disorder (FND) causes real neurological symptoms without structural damage detectable by routine tests.
- FND covers a spectrum including movement disorders and functional (non-epileptic) seizures and cognitive or sensory problems.
Brain Imaging Confirms Genuine Functional Changes
- Functional MRI shows distinct brain activity in FND compared with voluntary simulation and organic disease.
- This proves symptoms are not voluntary and confirms a genuine difference in brain processing.
Make A Positive Diagnosis Using Signs
- Use positive signs to diagnose FND; it is not solely a diagnosis of exclusion.
- Apply examination maneuvers like Hoover's sign to show preserved underlying function and explain findings to patients.