This meeting took place on Wednesday 12th July 2023. Liz Farrar-Moyles, a local private specialist physiotherapist with an interest in neuro-rehabilitation and FND, shared her knowledge on functional neurological disorders with the group. Liz can be contacted via her website www.lizfarrarphysio.com
Key learning points included:
- FND is a disorder of the voluntary motor or sensory system which has been linked to corruption of pre-conscious phases of motor planning (STONE, BURTON & CARSON, 2020)
- FND describes neurological symptoms like limb weakness, tremor, numbness or blackouts, related to the movement and sensation parts of the nervous system…..
- Caused by a PROBLEM with the FUNCTIONING of the nervous system
- A “software” issue of the brain, not the hardware (as in stroke or MS)
- With positive diagnostic features typical of FND
- Cause day to day difficulties for the person who experiences them
- 2nd most common reason to see a neurologist after headache
- 8,000 new diagnoses of FND are made per year in the UK
- Disproportionately affects women 3:1 although as age of onset increases the proportion of men increases
- Can occur across all ages (not common under 10)
- Patients are commonly polysymptomatic. Symptoms including gait disturbances, functional weakness, functional tremors and dissociative seizures.
- All suspected cases should be referred to a neurologist/specialist for diagnostic work up
- FND is a diagnosis of inclusion of positive signs. (But exclude other possibilities too!)
- FND can be diagnosed and treated in presence of comorbid, pathophysiologically defined disease
- Psychological stressors are important risk factors but are neither necessary nor sufficient for the diagnosis
- Don’t presume FND just because a presentation is unusual. There are many odd and unusual symptoms of other neurological conditions
Liz has kindly agreed for her presentation to be uploaded to the website for the benefit of the wider community. The presentation and Q&A from the meeting are attached below:
Useful FND Resources
https://neurosymptoms.org/en/ comprehensive website with factsheets, short videos,signposting to patient and professional organisations
FND Hope (www.fndhope.org) is an international patient-run registered charity for patients with functional neurological disorders. Can help patients find specialists.
Patient-led charity offering support and guidance to those diagnosed with FND and their caregivers. They host online support groups, provide an informative website and actively advocate for the cause.
Professional-led organisation
My FND app to help patients manage their symptoms
Neurokid was started in 2016 for children and young people with dissociative (non-epileptic) attacks/seizures and their families
http://www.nonepilepticattacks.info
Non-Epileptic Attacks is a website launched in February 2011 all about non-epileptic attacks. It’s written by a clinical team in Sheffield UK and has lots of useful information.
Attached below are the meeting presentation and question and answers:
Please be aware that information in the field of medicine changes all the time, so we cannot guarantee the accuracy of this data when you read it, it is here for General Practitioners to learn.