Materiały źródłowe

• #1 Functional neurologic disorder/conversion disorder – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conversion-disorder/symptoms-causes/syc-20355197

  Functional neurologic disorder a newer and broader term that includes what some people call conversion disorder features nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. […] Early diagnosis and treatment, especially education about the condition, can help with recovery. […] Seek medical attention for signs and symptoms that concern you or interfere with your ability to function. If the diagnosis is functional neurologic disorder, treatment may improve the symptoms and help prevent future problems. […] Some symptoms of functional neurologic disorder, particularly if not treated, can result in substantial disability and poor quality of life, similar to problems caused by medical conditions or disease.

• #2 Functional Neurologic Disorder | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/functional-neurologic-disorder

  Functional neurologic disorder (FND) refers to a neurological condition caused by changes in how brain networks work, rather than changes in the structure of the brain itself, as seen in many other neurological disorders. FND can cause multiple symptoms that significantly interfere with how a person functions and copes with daily life. Symptoms of FND are not intentionally produced and can involve any part of the body. Early diagnosis and treatment can help lessen symptoms and aid in healing. […] Strong, two-way communication between the healthcare provider and the patient is important for effective treatment of FND. This will help improve the patients understanding of the disorder and involve them actively in their own treatment. A team of doctors and health professionals from various specialties should work together with the individual to deliver a combination of treatments and comprehensive care. Currently, the two main treatment approaches include physical therapy and psychotherapy.

• #3 Functional neurologic disorder/conversion disorder – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/functional-neurologic-disorder-conversion-disorder/

  Functional neurologic disorder a newer and broader term that includes what some people call conversion disorder features nervous system (neurological) symptoms that cant be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning. […] Early diagnosis and treatment, especially education about the condition, can help with recovery. […] Seek medical attention for signs and symptoms that concern you or interfere with your ability to function. If the underlying cause is a neurological disease or another medical condition, quick diagnosis and treatment may be important. If the diagnosis is functional neurologic disorder, treatment may improve the symptoms and help prevent future problems. […] Treatment for functional neurologic disorder will depend on your particular signs and symptoms. For some people, a multispecialty team approach that includes a neurologist; psychiatrist or other mental health professional; speech, physical and occupational therapists; or others may be appropriate.

• #4 Functional Neurologic Disorder | Dallas, DFW, Ft. Worth TX — Mind + Body Medicine

  https://www.dallasmindbody.com/fnd

  Functional Neurologic Disorder (FND), formerly known as conversion disorder, is a neurological condition that can significantly affect the functioning of the nervous system. FND is common and ranks as the second most frequent cause after headaches for adults seeking consultation with a neurologist. Unlike many other neurological disorders, FND does not have an identifiable structural or organic cause. Instead, it is characterized by the brain’s dissociative response to stress or trauma, leading to a wide range of physical symptoms that may be debilitating. […] Treatment for FND typically involves a multidisciplinary approach, tailored to each patient’s unique needs. Some treatment options may include: Physical Therapy: To address motor and functional difficulties. Psychological Therapy: Managing underlying psychological factors. Occupational Therapy: Occupational therapists can help individuals develop strategies to improve their daily living skills, manage symptoms, and regain independence in their day-to-day activities. Medication: In some cases, medications may help alleviate symptoms. Supportive Care: Providing education and support to patients and their families. […] Understanding FND can be challenging for both patients and their family members, however, early diagnosis and prompt treatment can play a crucial role in symptom management and the path to recovery.

• #5 Conversion disorder Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/conversion-disorder

  Functional neurological disorder (FND) is a condition in which there is a problem with how the brain receives and sends information to one or more parts of the body. FND is not caused by a disease or injury. For reasons not understood, the nervous (neurological) system does not work properly. […] FND symptoms may include weakness and paralysis of the limbs, seizures, tremors and jerks, and other nervous system symptoms. […] Treatment for FND will depend on what symptoms you experience. You may work with different providers, including: Neurologists, Mental health professionals, Primary care providers, Speech, physical, or occupational therapists. […] Treatments may include: Talk therapy, Cognitive behavior therapy to help alter thought patterns, emotions, behaviors and mood, Relaxation and mindfulness exercises to manage stress, Physical, speech, and occupational therapy, Other treatments as necessary. […] It can also help to learn about FND and understand that your symptoms are real, even without a medical cause. Knowing that there is no serious medical cause may help you feel less anxious and more able to cope.

• #6 Conversion Disorder: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17975-conversion-disorder

  Functional neurological symptom disorder better known as conversion disorder is a mental health condition that causes physical symptoms. The symptoms happen because your brain converts the effects of a mental health issue into disruptions of your brain or nervous system. The symptoms are real but dont match up with recognized brain-related conditions. […] Its important to know that conversion disorder is a real mental health condition. Its not faking or attention-seeking. It isn’t just something in a persons head or that theyve imagined. While its a mental health condition, the physical symptoms are still real. A person with conversion disorder cant control the symptoms just by trying or thinking about it. […] Conversion disorder is a mental health condition that causes physical symptoms. Because of that, treating the mental health component with some form of psychotherapy (mental health therapy) is usually the first approach. Its also usually the most successful approach. The most common types of psychotherapy include:

• #7 Functional neurologic disorder/conversion disorder – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conversion-disorder/diagnosis-treatment/drc-20355202

  There are no standard tests for functional neurologic disorder. Diagnosis usually involves assessment of existing symptoms and ruling out any neurological or other medical condition that could cause the symptoms. […] Functional neurologic disorder is diagnosed based on what is present, such as specific patterns of signs and symptoms, and not just by what is absent, such as a lack of structural changes on an MRI or abnormalities on an EEG. […] Testing and diagnosis usually involves a neurologist but may include a psychiatrist or other mental health professional. Your health care provider may use any of these terms: functional neurologic disorder (FND), functional neurological symptom disorder or an older term called conversion disorder. […] Treatment for functional neurologic disorder will depend on your particular signs and symptoms. For some people, a multispecialty team approach that includes a neurologist; psychiatrist or other mental health professional; speech, physical and occupational therapists; or others may be appropriate.

• #8 Functional Neurologic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551567/

  Psychotherapy is the first-line treatment in most cases of functional neurologic disorder. Different types of therapy can be useful, but the most effective throughout the literature seems to be cognitive-behavioral therapy (CBT). […] Another first-line treatment that clinicians should offer in conjunction with CBT is physical therapy. This approach is more useful for functional motor symptoms and helps patients feel as though their clinical team takes their symptoms seriously. […] The presence of symptoms defines an acute episode of functional neurologic disorder for less than six months, and persistent functional neurologic disorder includes the presence of symptoms for greater than six months. […] The diagnostic criteria for functional neurologic disorder, according to the DSM-5TR, are as follows: One or more symptoms of altered voluntary motor or sensory function.

• #8 Functional Neurologic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551567/

  Functional neurologic disorder, formally conversion disorder, is a psychiatric disorder characterized by signs and symptoms affecting sensory or motor function inconsistent with patterns of known neurologic diseases or other medical conditions and significantly impacting the patients ability to function. […] This activity illustrates the diagnosis, evaluation, and management of functional neurologic disorder and reviews the role of the interprofessional team in improving care for patients with this condition. […] The first step in the treatment of functional neurologic disorder involves an effective presentation of the diagnosis to the patient. General recommendations are that the clinician does not reveal the diagnosis during the first encounter. Instead, it is essential to build a strong therapeutic alliance with the patient.

• #9 Functional neurological disorder (FND) | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/functional-neurological-disorder/

  Functional neurological disorder (FND) describes a problem with how the brain receives and sends information to the rest of the body. […] A specialist will diagnose functional limb weakness based on specific clinical features (symptoms) they find when they examine you. […] A specialist will ask you and your friends or family about what happens during a seizure, and will look at any video footage you can provide. […] A specialist will diagnose functional tremor based on specific features of your symptoms that they find when they examine you. […] A specialist will diagnose functional gait disorder based on clinical features, like the way your walking changes when doing different activities. […] A specialist will diagnose functional speech and swallowing difficulties based on specific features.

• #10 Caring for Patients with Functional Neurological Disorders in the ED: Updates, Pearls, and Pitfalls – EMOttawa Blog

  https://emottawablog.com/2018/10/functional-neurological-disorders/

  Functional Neurological Disorder is not a diagnosis of exclusion. It is a diagnosis based on positive clinical features. […] Important to recognize FND early and as ED physicians we are well-positioned to do so given the high presentation rate. […] The symptom or deficit causes clinically significant distress or impairment. […] Avoid investigations and admissions if possible. […] Elements of an evidence-based therapeutic disclosure: Explain what they do have, the mechanism of the symptoms, how you made the diagnosis, you believe them, reversibility. […] Common pitfalls in disclosing the diagnosis: Telling them what they don’t have and expecting them to be satisfied, preemptively attributing their symptoms to psychological problems, using the negative workup as the evidence for their diagnosis.

• #11 Functional neurological disorder (FND) | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/functional-neurological-disorder/

  When diagnosing FND, your healthcare provider will carry out an assessment to see if there are typical clinical features of FND. […] The diagnosis of FND, however, should be given because you have the clinical features of FND. […] There are treatments available that can manage and improve FND. […] Specialised physiotherapy can be useful in treating FND. […] Occupational therapy can be helpful in treating FND. […] Psychological therapy can be helpful to many people with FND, even those without stress in their lives. […] Speech and language therapists are available to help if you’re struggling with speaking or swallowing. […] Medication can play a role in treating the some of the problems associated with FND, like pain, depression and anxiety.

• #12 Functional Neurologic Disorder – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK551567/

  The complications of functional neurologic disorder include permanent disability and impaired quality of life. […] All cases of functional neurologic disorder can benefit from an interprofessional team approach. […] Frequent follow-up prevents the patient from visiting other facilities, such as urgent care or the emergency department.

• #13 Somatoform Disorders Nursing Care Management – Nurseslabs

  https://nurseslabs.com/somatoform-disorders/

  Somatoform disorders refer to a group of mental health conditions where individuals experience physical symptoms or complaints that cannot be fully explained by any underlying medical condition or organic pathology. […] In this disorder, individuals experience neurological-like symptoms, such as weakness, paralysis, seizures, or difficulty swallowing, without any detectable neurological cause. […] Nursing management of a patient with somatoform disorders include the following: […] The nurse must investigate physical health status thoroughly to ensure there is no underlying pathology requiring treatment. […] Based on the assessment data, the major nursing diagnoses are: […] The major nursing care plan goals for patients with somatoform disorders are: […] The nursing interventions for somatoform disorders are: […] Treatment outcomes include: […] Documentation in a client with somatoform disorders includes the following:

• #14 Conversion Disorder: Symptoms, Treatment & DSM 5

  https://www.vaia.com/en-us/explanations/nursing/mental-health-nursing/conversion-disorder/

  Conversion Disorder is seen in the field of nursing as patients present with physical symptoms that cannot be traced to a medical cause. These symptoms often occur following a stressful situation or emotional conflict, suggesting a 'conversion’ of mental distress into physical symptoms. […] A complex correlation exists between Conversion Disorder and other mental health disorders, especially mood and anxiety disorders. It’s also linked with certain personality disorders. At times, these conditions may co-exist with Conversion Disorder. […] Nursing care plays a significant role in managing these patients, which not only involves looking after the physical symptoms but also providing psychological support, educating about the disorder, and involving the patient actively in the care plan.

• #15 Conversion Disorder: Symptoms, Treatment & DSM 5

  https://www.vaia.com/en-us/explanations/nursing/mental-health-nursing/conversion-disorder/

  The treatment course depends on distinct aspects such as the intensity of the symptoms, the person’s emotional health, whether there are concurring mental or physical health disorders, and most importantly, the person’s willingness to participate in treatment. […] Professional treatment in Conversion Disorder is a tailored therapeutic approach that prioritises the clinical needs of the patient, considering their specific symptoms and relevant psychological factors. […] The first step towards treatment is usually encouraging the individual to agree to psychological assistance. […] Therapy and counselling prove to be particularly effective in treating Conversion Disorder. […] Nursing interventions can support recovery from Conversion Disorder by providing a safe environment, facilitating physical rehabilitation, and offering emotional support. […] Providing information about the disorder, explaining the mind-body connection, and demystifying treatment can help resolve anxieties and misconceptions about the disorder.

• #16 Functional neurologic disorder/conversion disorder – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/functional-neurologic-disorder-conversion-disorder/

  Understanding what functional neurologic disorder is, that the symptoms are real, and that improvement is possible can help you with treatment choices and recovery. […] Your medical team provides treatment of any underlying neurological or other medical disease you may have that might be a trigger for your symptoms. […] Depending on your needs, therapies may include: Physical or occupational therapy. Working with a physical or occupational therapist may improve movement symptoms and prevent complications. […] Regular follow-up with your medical team is important to monitor your recovery and make changes to your treatment plan as needed. […] Medications are not effective for functional neurologic disorder, and no drugs are approved by the Food and Drug Administration specifically as a treatment. However, medications such as antidepressants may be helpful if you also have depression or other mood disorders, or you’re having pain or insomnia.

• #17 Mayo Clinic Health Library – Functional neurologic disorder/conversion disorder | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20228115

  Functional neurologic disorder a newer and broader term that includes what some people call conversion disorder features nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning. […] Early diagnosis and treatment, especially education about the condition, can help with recovery. […] Treatment for functional neurologic disorder will depend on your particular signs and symptoms. For some people, a multispecialty team approach that includes a neurologist; psychiatrist or other mental health professional; speech, physical and occupational therapists; or others may be appropriate. […] Understanding what functional neurologic disorder is, that the symptoms are real, and that improvement is possible can help you with treatment choices and recovery. Symptoms may get better after an explanation of the condition and reassurance from your health care provider that symptoms are not caused by a serious underlying neurological or other medical disorder. […] Regular follow-up with your medical team is important to monitor your recovery and make changes to your treatment plan as needed.

• #18 What Is FND – FND Hope International

  https://fndhope.org/fnd-guide/

  Functional Neurological Disorder (FND) is a problem with the functioning of the nervous system and how the brain and body send and receive signals. Physical and/or psychological risk factors can cause functional symptoms which include a variety of physical, sensory and cognitive symptoms that have yet to be explained by a recognised disease. […] The most important first step toward a successful treatment for Functional Neurological Disorder comes from clear and effective communication in a mutually respectable environment. The clinicians ability to explain the diagnosis and educate the patient is of critical importance to the subsequent likelihood of successful treatment. Evidence is now emerging for the utility of multidisciplinary treatment, especially specific physical therapy (for motor symptoms) and psychotherapy (for attacks or seizures).

• #19 Functional Neurological Disorders: Exploring Unmet Needs – UT Southwestern Medical Center

  https://physicianresources.utswmed.org/news/functional-neurological-disorders-exploring-unmet-needs

  FNDs have a high association with a history of prior trauma, as well as medical comorbidities, such as mild traumatic brain injury, fibromyalgia, chronic fatigue syndrome, and chronic pain syndrome, Dr. Lane explains. […] For effective treatment, neurologists, psychiatrists, psychotherapists, and rehabilitative therapists must all collaborate closely in the care of patients, Dr. Lane explains, adding that currently there is a dearth of FND-focused specialty care across the Unites States. […] The mainstay of treatment, Dr. Lane notes, is psychotherapy and rehabilitative therapies, including physical, occupational, and speech therapies. Medications can have a role in the management of co-occurring conditions, including depression, trauma-related disorders, and anxiety. […] Multidisciplinary treatment teams are fundamental to the successful care of patients with an FND, Dr. Lane says.

• #20 Functional Neurological Disorder (FND) – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurology/functional-neurological-disorder

  Our group meets regularly to discuss patients clinical progress and can offer consultations to clinicians to help with management of some of their more complex patients with FND. […] The clinical components may include: An initial clinical assessment by an expert neurologist, physical medicine expert, neuropsychiatrist and/or social worker; A discussion of the diagnosis and treatment plan with the patient and referring provider; A care management component to help ensure treatment recommendations are implemented by the treatment team (either at BWH or closer to the patient); If appropriate and feasible, multidisciplinary short-term treatment that involves treatment by a dedicated physical therapist, a specialized psychotherapist, follow-up with neurology and neuropsychiatry; At the end of the treatment, a discussion of long-term needs with appropriate community referrals, if applicable.

• #21 Basics of Functional Neurological Disorder (FND)

  https://www.massgeneral.org/neurology/treatments-and-services/functional-neurological-disorder-basics

  Functional neurological disorder (FND) is a problem largely impacting the function of the brain. […] FND symptoms are potentially reversible. However there are generally no quick fixes. Treatment focuses on teaching you how to retrain your brain helping you bring your movements, speech, thinking, or other neurological symptoms back to normal function. Treatment depends on the FND symptoms you have and is often multidisciplinary. This means that care providers from different specialties, like physical therapy and social work/psychology, can often times be involved in patient care. […] Because FND is a complex problem, sometimes with complex treatments, you, as the patient, are an important member of the treatment team. We rely on you to practice the skills you learn with our treatment team, keep an open mind, and let us know what works and what doesnt.

• #22 Functional Neurologic Disorder | National Institute of Neurological Disorders and Stroke

  https://www.ninds.nih.gov/health-information/disorders/functional-neurologic-disorder

  Psychotherapy involves talking with a licensed and trained mental health professional about negative or troublesome emotions, behaviors, and thoughts. Cognitive behavior therapy (CBT) can help a person modify their thought patterns to change emotions, mood, or behavior. Psychodynamic therapy can help people identify and resolve patterns in thoughts, beliefs, and emotions that may cause some of the neurological symptoms. Relaxation and mindfulness exercises can help reduce stress. Some individuals benefit from hypnosis to induce relaxation and lessen FND symptoms. […] Medications are available to treat pain, anxiety, depression, insomnia, and headache that may occur with FND. People with functional seizures should not take anti-seizure medications. Anti-seizure medications do not treat functional symptoms like they do epileptic seizures and might even worsen the symptoms.

• #23 Conversion Disorder: Causes, Symptoms, and Treatment

  https://www.webmd.com/mental-health/what-is-conversion-disorder

  Conversion disorder is a condition in which you have physical symptoms but no injury or illness to explain them. […] A newer name for conversion disorder is functional neurologic disorder (FND). In the American Psychiatric Association (APA) diagnostic manual, DSM-5, conversion disorder and FND are listed as the same condition. […] The treatments you could have include: Psychotherapy: Talking with someone about your stress can help you better manage your stress. […] Physical therapy: A trained expert can help you manage pain and improve how well you move. […] Cognitive behavioral therapy: This type of therapy is often used to treat conversion disorder. It helps you learn to spot and change negative thought patterns that affect what you do. […] The earlier you seek treatment, the better your outlook. Try to find a doctor you can talk openly with and who listens to you. Once you do start treatment, follow through with your doctor’s advice and go to all your follow-up visits.

• #24 Functional Neurological Symptom Disorder – Mental Health Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/mental-health-disorders/somatic-symptom-and-related-disorders/functional-neurological-symptom-disorder

  In functional neurological symptom disorder, physical symptoms that resemble those of a nervous system (neurologic) disorder develop. The symptoms can follow mental factors such as conflicts or other stresses. […] A supportive, trustful doctor-patient relationship can help, as can hypnosis and psychotherapy, including cognitive-behavioral therapy. […] Symptoms are not consciously produced. That is, people are not faking their symptoms. Symptoms are severe enough to cause substantial distress and/or interfere with functioning. […] A supportive, trustful doctor-patient relationship is essential. The most helpful approach may involve collaboration of a primary care doctor with a psychiatrist and a doctor from another field, such as a neurologist. […] Hypnosis may help by enabling people to control how stress and other mental states affect their bodily functions. […] Psychotherapy, including cognitive-behavioral therapy, is effective for some people.

• #25 Functional Neurological Disorder: Historical Trends and Urgent Directions | Velazquez-Rodriquez | Journal of Neurology Research

  https://www.neurores.org/index.php/neurores/article/view/754/722

  Given the disappointing outcomes and prognosis, neurologists have focused on improving the treatments provided to the FND population, including physical therapy (PT) and psychotherapy. […] PT is an integral part of the treatment of many FND subtypes. […] Various PT techniques have demonstrated benefits, such as movement retraining for functional motor symptoms, and walking for functional movement disorder. […] CBT is a top-down psychotherapeutic modality that works under the premise that a persons thoughts and beliefs affect feelings and behaviors. […] The evidence supporting the use of CBT in FND goes back to the last century. […] The first RCT involving CBT for FS patients was conducted in 2015, assessing the effect of adding CBT to SMC and psychiatric care in 368 patients. […] Multidisciplinary or multimodal care for FND involving family medicine, neurological, psychiatric, psychological care, and if needed physiotherapy, are being used in clinical practice, although they are not widely available, and often require patients to access care at far away hospitals and academic centers. […] The creation of a comprehensive, pathologically focused, multi-network treatment algorithm is not a simple task and must be designed through multidisciplinary collaborative efforts, overcoming the detrimental effects of medical specialists separateness in FND management.

• #26 From conversion disorders to functional neurological disorders. Overcoming the rule-out diagnosis? | Revista Colombiana de Psiquiatría (English Edition)

  https://www.elsevier.es/en-revista-revista-colombiana-psiquiatria-english-edition–479-articulo-from-conversion-disorders-functional-neurological-S2530312019300281

  Once the diagnosis is clear, its nature should be communicated appropriately to the patient. […] Patients should be shown simple distraction strategies (music, walking, alternating gait patterns) to interfere in the case of abnormal movements. […] Specialist physiotherapy is currently a key point in the multidisciplinary care of patients with functional movement disorders. […] Cognitive behavioural therapy (CBT) has been studied in the treatment of NES, with positive results. […] The use of suggestion in hypnosis for the treatment of functional symptoms has increased in recent decades. […] To conclude, functional neurological disorders are made up of a range of diverse symptoms which are disabling for patients and highly prevalent in general and specialised medical consultations.

• #27 Functional Neurologic Disorder | Dallas, DFW, Ft. Worth TX — Mind + Body Medicine

  https://www.dallasmindbody.com/fnd

  Functional Neurologic Disorder (FND), formerly known as conversion disorder, is a neurological condition that can significantly affect the functioning of the nervous system. FND is common and ranks as the second most frequent cause after headaches for adults seeking consultation with a neurologist. Unlike many other neurological disorders, FND does not have an identifiable structural or organic cause. Instead, it is characterized by the brain’s dissociative response to stress or trauma, leading to a wide range of physical symptoms that may be debilitating. […] Treatment for FND typically involves a multidisciplinary approach, tailored to each patient’s unique needs. Some treatment options may include: Physical Therapy: To address motor and functional difficulties. Psychological Therapy: Managing underlying psychological factors. Occupational Therapy: Occupational therapists can help individuals develop strategies to improve their daily living skills, manage symptoms, and regain independence in their day-to-day activities. Medication: In some cases, medications may help alleviate symptoms. Supportive Care: Providing education and support to patients and their families. […] Understanding FND can be challenging for both patients and their family members, however, early diagnosis and prompt treatment can play a crucial role in symptom management and the path to recovery.

• #28 Functional neurologic disorder/conversion disorder – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/conversion-disorder/diagnosis-treatment/drc-20355202

  Understanding what functional neurologic disorder is, that the symptoms are real, and that improvement is possible can help you with treatment choices and recovery. […] For some people, education and reassurance that they don’t have a serious medical problem is the most effective treatment. […] Your medical team provides treatment of any underlying neurological or other medical disease you may have that might be a trigger for your symptoms. […] Depending on your needs, therapies may include: Physical or occupational therapy. Working with a physical or occupational therapist may improve movement symptoms and prevent complications. […] Even though functional neurological symptoms are not „all in your head,” emotions and the way you think about things can have an impact on your symptoms and your recovery. […] Regular follow-up with your medical team is important to monitor your recovery and make changes to your treatment plan as needed.

• #29 Functional Neurological Disorders: Exploring Unmet Needs – UT Southwestern Medical Center

  https://physicianresources.utswmed.org/news/functional-neurological-disorders-exploring-unmet-needs

  Assuring patients that their symptoms are real and brain-based, providing a helpful metaphor such as FND being a software rather than a hardware problem, and delivering the diagnosis with compassion, empathy, and confidence are all critical to setting a patient on the right treatment trajectory. […] The Peter ODonnell Jr. Brain Institute Functional Neurological Disorder Clinic is made up of neurologists, psychotherapists, psychiatrists, rehabilitative therapists, and speech-language pathologists. […] It is funded in part by an award from the OBIs Clinical Neuroscience Scholars Program and is one of only a handful of centers in the nation to take a comprehensive approach to managing FNDs, with staff working together to address the physical, psychological, and social aspects of these disorders.

• #30 Functional Neurological Disorders (FND) Treatment Program

  https://www.massgeneral.org/neurology/treatments-and-services/functional-neurological-disorder

  The Massachusetts General Hospital Functional Neurological Disorder (FND) outpatient clinic is a multidisciplinary and interdisciplinary short-term treatment program for adults (18+) seeking diagnostic clarity and treatment for FND. […] Our clinical program diagnoses and treats individuals suffering from symptoms such as: Functional limb weakness or paralysis, Functional (dissociative) seizures, Functional movement disorders such as tremor, jerks, tics, gait disorders or dystonia, Functional speech disorders, Functional cognitive disorders, Persistent postural-perceptual dizziness (PPPD). […] The Mass General Functional Neurological Disorder Unit particularly specializes in treating people with functional motor symptoms that lie at the intersection of neurology and psychiatry. Our clinic is interdisciplinary this means that at your first visit your doctor will go over a neurological and psychiatric history and physical examination. Our clinic is also multidisciplinary this means that after your initial visit we recommend components of treatment based on your needs. Personalized, short-term (time-limited) treatments we recommend can include: Physical therapy, Occupational therapy, Speech and language therapy, Skills-based or problem-focused psychotherapy, such a cognitive-behavioral therapy (CBT), Group psychotherapy (pilot program).

• #31 Functional Neurological Disorders: Exploring Unmet Needs – UT Southwestern Medical Center

  https://physicianresources.utswmed.org/news/functional-neurological-disorders-exploring-unmet-needs

  Upon initial presentation, patients are evaluated by both a psychiatrist and psychotherapist, who then formulate a treatment plan. […] Subsequently, most patients are referred to the clinics eight-week, evidence-based group therapy program, designed specifically for the treatment of FNDs. […] Only a few centers can provide this particular type of therapeutic intervention, Dr. Lane says. We bring together a collaborative team of neurologists, psychiatrists, psychotherapists, and rehabilitative therapists, each actively participating in the patients care. […] Importantly, prompt diagnosis allows for more rapid implementation of appropriate evidence-based interventions.

• #32 Functional Neurological Disorder (FND) – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurology/functional-neurological-disorder

  We treat patients with Functional neurological symptoms that may include weakness, cognitive problems, dizziness, seizure-like spells, speech or sensory dysfunction which are not compatible with any recognized neurologic condition. […] Our clinical and research multidisciplinary program for Functional Neurological Disorders (FND) at BWH is comprised of professionals from multiple disciplines (Psychiatry, Neurology, Physiatry, Social Work and Physical Therapy) committed to provide state-of-the-art clinical care to patients with FND. […] It is essential that the referring clinician remain involved in the patients care as our goal is to improve the care of the patient which involves supporting and educating the referring team rather than just transferring care.

• #33 Functional Neurological Disorder Program | Department of Psychiatry and Behavioral Sciences | Stanford Medicine

  https://med.stanford.edu/psychiatry/patient_care/fnd.html

  Functional Neurological Disorder (FND) is used to describe neurologic symptoms incompatible with an established medical illness. […] The Functional Neurological Disorder Program in the Department of Psychiatry and Behavioral Sciences at Stanford treats patients suffering from FND with a collaborative, multidisciplinary approach. […] Patients completing time-limited FND treatment at Stanford or unable to participate with on-site therapy will receive treatment plans designed around the local resources available to the client. […] Physical and occupational therapists utilize a therapy protocol designed specifically for functional movement disorders and paralysis. […] All programs require a diagnosis of FND or conversion disorder by a neurologist with supportive documentation. […] Patients are offered an opportunity to participate in national and international studies investigating FND diagnosis and treatment throughout the process of evaluation and treatment. […] Our team created the two educational videos below. In these videos, we used clinical neuroscience in discussing the diagnosis of FND and treatment options.

• #34 Functional neurological symptom disorder – Wikipedia

  https://en.wikipedia.org/wiki/Functional_neurological_symptom_disorder

  Physiotherapy with someone who understands functional disorders may be the initial treatment of choice for patients with motor symptoms such as weakness, gait (walking) disorder and movement disorders. […] For many patients with FNSD, accessing treatment can be difficult. Availability of expertise is limited and they may feel that they are being dismissed or told „it’s all in your head” especially if psychological input is part of the treatment plan.

• #35 Psychiatric Comorbidities in Functional Neurologic Symptom Disorder

  https://practicalneurology.com/diseases-diagnoses/epilepsy-seizures/psychiatric-comorbidities-in-functional-neurologic-symptom-disorder/31889/

  Functional neurologic symptom disorder (FND) is among the most frequently encountered conditions in the outpatient neurology setting and is difficult to treat, with poor prognoses and significant disability and morbidity. […] Proper delivery of information related to FND diagnosis and psychologic care are essential for successful treatment of FND. […] Psychiatric comorbidities in FND are common and associated with poorer outcomes, including lower quality of life (QOL) and decreased survival for most medical disorders. […] Many, however, receive treatment outside of the preferred multidisciplinary clinics that are best suited for FND treatment. […] The presence of social support is related to secure attachment, but it is the quality of the partnership and not the mere presence of a live-in partner that influences recovery in FND.

• #36 Functional Movement Disorders – Emory Healthcare

  https://www.emoryhealthcare.org/conditions/neurology-conditions/functional-movement-disorders

  Functional neurological disorders represent a group of disorders where there are often distressing and disabling neurological signs and symptoms that occur which cannot be accounted for by other known disease entities. […] With functional neurological disorders, there is no structural damage or degeneration of the nervous system. Instead there is a functional problem (or malfunction) of the brain which is often reversible. […] The diagnosis of functional movement disorders is generally made by neurologists, not psychiatrists. […] Despite the frequent occurrence of FMD, there are no standardized treatments and this requires more research. […] Successful treatment plans must be individualized based on clinical features, and that the earlier the diagnosis is made and treatment is started, the greater likelihood of reversal of the symptoms. […] Regardless of the approach, critical to the care plan is clear communication and understanding of the diagnosis by both the healthcare providers and the patients and long term follow-up by the physician. When patients receive the right care symptoms can improve or even resolve.

• #37 Functional Neurological Disorder: Historical Trends and Urgent Directions | Velazquez-Rodriquez | Journal of Neurology Research

  https://www.neurores.org/index.php/neurores/article/view/754/722

  Given the many symptoms individuals with FD present, it would be advantageous for neurologists to collaborate with other specialists, including rheumatologists, pain management, gastroenterologists, as well as members of the DSM workgroup, to create a more accurate and comprehensive mind-body classification system, clarifying that what is being increasingly recognized is an umbrella of FD. […] A comprehensive management protocol capable of targeting the shared pathophysiological mechanisms across FD will be more easily developed. […] A review of 24 studies performed between 1940 and 2013 involving functional tremor, dystonia, parkinsonism, weakness and FND with mixed symptoms, described complete remission in only 20% of the patients, with 40% staying the same or becoming worse over a 7.4 years follow-up period.

• #38 Conversion Disorder Symptoms & Treatment | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/conversion-disorder

  A conversion disorder, also called functional neurologic disorder, is a medical condition in which the patient loses the use of some part of his or her body without an apparent physiological reason. […] Left untreated, conversion disorder can result in long-term disability and a much reduced quality of life. […] Treating conversion disorders often involves a multipronged approach: Medical understanding: An important first step in dealing with conversion disorder is understanding that your symptoms are real and not just all in your mind. […] For individuals experiencing loss of movement or coordination, physical, occupational, and/or speech therapy can be effective means of learning old skills anew. […] The outlook for persons with conversion disorder is generally positive. Understanding and treatment are often beneficial in addressing symptoms, which sometimes disappear as suddenly as they first appeared.

• #39 Somatic Symptom and Related Disorders (SSRDs) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/somatic-symptom-and-related-disorders-ssrds

  Functional neurologic disorders previously called conversion disorder, including functional movement disorders or dystonia, functional tic disorder, and functional tremor […] SSRD treatment aims to repair communication between the mind and body. This will improve the child’s ability to function and participate in daily life at home, at school and with friends. […] The goal of treatment for all SSRDs is to break the symptom cycle and repair the mind-body connection. […] The best outcomes are seen with a return to daily schedules and activities, even if the child still has symptoms. […] Therapies will focus on strengthening communication between the mind and body. […] SSRDs are treatable, though it may take time and practice to repair the communication pathways. Most children diagnosed with a somatic disorder will see improvement or resolution of their symptoms with proper treatment.

• #40 Functional Neurologic Disorder (FND) | Conditions & Treatments | UR Medicine

  https://www.urmc.rochester.edu/conditions-and-treatments/functional-neurologic-disorder

  Functional neurological disorder (FND) is a condition where individuals experience neurological symptoms, such as weakness, movement problems, tremors, and seizures/attacks that cannot be attributed to a clear neurological disease. […] FND is usually treated with a team approach. For example, you may first see a mental health professional, with follow-up to physical therapy, occupational therapy, speech therapy, and neurology per your symptoms. An individualized treatment plan is created for each patients unique situation. […] A core value within URs Departments of Neurology and Psychiatry is viewing our patients holistically, considering all aspects of their lives during treatment. Treatment focuses on rehabilitation, understanding the condition, identifying triggers and warning signs, and improving coping. The goal is to improve your functioning and quality of life.

• #41 Functional neurological and somatic symptom disorders – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/989

  Functional neurological disorder (previously termed conversion disorder) and somatic symptom disorder are both characterised by somatic symptoms associated with significant distress or impairment. […] Good therapeutic alliance, validation of the patient’s suffering, and shared clinician-patient understanding of the condition are essential for effective management. […] Treatment includes cognitive behavioural therapy, physiotherapy, and avoiding unnecessary medicines, tests, and procedures. Diagnosis and treatment of associated comorbid psychiatric conditions can benefit overall functioning and recovery.

Zobacz więcej