Physical rehabilitation for FND

Question 1

What are some symptoms seen in those with FND?

Answer 1

In the past some believed that there was a psychological cause.
Psychological factors are important but not a universal experience for all patients.

Motor - weakness, altered walking, tremor, dystonia.
Sensory - numbness, pins, and needles
Functional seizures - looks like epilepsy.
PPPD - persistent perceptual postural disease.
Cognitive - difficult concentrating, fearful that they have dementia

physical symptoms: fatigue, pain and headache.
psychological symptoms: depression and anxiety

Question 2

What is the prognosis for FND?

Answer 2

Prognosis is a medical term for predicting the likelihood or expected development of a disease, including whether the signs and symptoms will improve or worsen or remain stable over time.

Functional neurological disorder has an overall poor prognosis; however, children and young adults appear to have a better outcome.

This group followed up:
20% resolved.
80% still had symptoms.

Question 3

What is the bio psychosocial model for FND?

Answer 3

biological: history of illness, injury, neuroplasticity

psychological: personality traits (obessesive and perfectionist), anxiety, acute panic attack, fear

social: neglect, social stressors, financial stressors.

Question 4

What is the treatment plan for FND?

Answer 4

-communicate the diagnosis (tell them what the problem is (describe FND), how symptoms occur (mismatch), possible triggers (anxiety, depression, life stresses), risk factors (male and other neurological disorders, psychiatric disorders), how diagnosis is done, treatment options, plan to follow up

-MDT care- psychology, physiotherapy (helps with strength, better coordination and balance), occupational therapy, speech therapy, language therapy, exercise instructors

-psychology - CBT for psychological manifestations, talking therapy, stress coping mechanisms, psychoeducation

-education (attention and entrainment) to help understand diagnosis

-complentary therpaies like acupuncture and massage therpay - helpful for pain relief and relieving muscle tension

-medication: anti-depressants, pain relief medication.