Experts discuss functional neurologic disorders including diagnosis, phenotypes, causes, and treatments. They highlight the importance of patient engagement, accurate diagnosis, and a holistic approach to treatment. The podcast emphasizes the need for collaboration between neurologists, psychotherapists, and psychiatrists in managing functional seizures and psychogenic non-epileptic events.
Identifying new phenotypes in Functional Neurologic Disorder (FND) through clinical signs and neurologic examinations is crucial for accurate diagnosis.
Genetic predisposition, childhood trauma, and adverse life events contribute to the development of FND symptoms, indicating a complex interplay of factors.
Tailoring individualized treatment strategies for FND, including education, physiotherapy, and psychological therapies, fosters collaborative care and improves patient outcomes.
Deep dives
Understanding FND: Diagnosis and New Phenotypes
Functional Neurologic Disorder (FND) refers to a medical condition where patients present with varied neurological symptoms like weakness and abnormal movements, stemming from brain dysfunction. Contrary to past beliefs of FND as a diagnosis of exclusion, it is now viewed as a positive diagnosis with clinical signs. This shift has led to the identification of new phenotypes through neurologic examinations and specific criteria.
Unveiling the Pathophysiology of FND: Neuroimaging Insights
Neuroimaging studies have shed light on the brain's altered oxygen consumption in FND patients, suggesting dysfunction in brain circuits like the sense of agency network and limbic system. These findings point towards a complex interplay of genetic predisposition, childhood trauma, and adverse life events triggering FND symptoms. The evolving understanding hints at gene-environment interactions contributing to the condition.
Patient-Centered Treatment Approach for FND
Treatment for FND emphasizes individualized approaches, combining education, physiotherapy, psychological therapies, and multidisciplinary care. The focus lies on patient's top concerns to tailor treatments effectively. By fostering a collaborative environment and leveraging resources like reliable educational materials, neurologists can navigate the complexities of sharing an FND diagnosis with empathy and normalize the condition within the spectrum of human illness for improved patient outcomes.
Recommendations from Therapists on Treating F&D
In the podcast episode, it is highlighted that therapists provided consensus recommendations for treating Functional Neurological Disorders (F&D) based on their experiences. Therapists from physical therapy, occupational therapy, and speech and language therapy emphasized promoting automatic movements in F&D to retrain the brain and address unhelpful voluntary patterns. The recommendations aimed to shift focus towards good mobility patterns and positive signs during patient examinations. This approach emphasized collaborative and intuitive strategies shared among therapists, showcasing the importance of tailored therapeutic techniques.
Importance of Accurate Diagnosis and Management for PNE
The episode discussed the significance of accurately diagnosing and managing Psychogenic Non-Epileptic Events (PNE) to improve patient outcomes. Providing clear language during diagnosis, validating patient experiences, and differentiating PNE from epilepsy were highlighted as essential steps. The episode emphasized the need to discontinue anti-seizure medications for patients with PNE to achieve resolution of events. Additionally, early and accurate diagnosis, along with proper management, including cognitive behavioral therapy, were underscored as crucial factors in impacting the prognosis of patients with PNE.
The April 2024 replay of past episodes showcases four incredible interviews on functional neurologic disorders. The episode begins with the 3-part FND roundtable discussion with Prof Jon Stone discussing various topics in FND with Drs. Selma Aybek, David Perez, and Sarah Lidstone. In the first discussion they touch on FND diagnosis and exploring new phenotypes. The second discussion is on how and why FND and the third discussion is on treatments for FND. The episode concludes with Dr. Halley Alexander’s conversation with Dr. Genna Waldman about reviewing psychogenic non-epileptic events.
