Management of functional neurological disorder

• Published in: Journal of neurology Vol. 267; no. 7; pp. 2164 - 2172
• Main Authors: Gilmour, Gabriela S., Nielsen, Glenn, Teodoro, Tiago, Yogarajah, Mahinda, Coebergh, Jan Adriaan, Dilley, Michael D., Martino, Davide, Edwards, Mark J.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.07.2020; Springer Nature B.V
• Subjects: Chronic pain; Cognitive ability; Conversion Disorder - diagnosis; Conversion Disorder - physiopathology; Conversion Disorder - therapy; Disease Management; Epilepsy; Humans; Medicine; Medicine & Public Health; Nervous System Diseases - diagnosis; Nervous System Diseases - physiopathology; Nervous System Diseases - therapy; Neurological disorders; Neurological Update; Neurologists; Neurology; Neuroradiology; Neurosciences; Psychophysiologic Disorders - diagnosis; Psychophysiologic Disorders - physiopathology; Psychophysiologic Disorders - therapy; Seizures; Psychogenic nonepileptic seizures; Functional seizures; Functional neurological disorder; Functional movement disorder; Psychogenic movement disorder
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-020-09772-w

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.