FND Flashcards
(24 cards)
normally there are __ neural networks
7-17
what is FND?
disorder of neural network communication; function rather than physical changes in brain
rule in signs of FND
variable
distractible
entrainable
suppressible
T/F: FND is a diagnosis of exclusion
F
DSM 5 criteria for FND diagnosis
> /= 1 sx of altered voluntary motor or sensory function
T/F: a prior stressful life event or psychiatric comorbidity is enough for a FND diagnosis
F (must have rule in signs)
positive tests for FND
- entrainment test
- whack a mole sign
- varying frequency and/or direction of tremor
- Hoover’s sign
- increase performance with dual-task
- attention to body increases abnormal movement or weakness
- drift w/o pronation
- drag leg w/o circumduction
- speech issues
FND diagnosis pattern
- variable
- distractible
- sudden onset
- global weakness w/ no pattern
- suppressible
- entrainable
- full remissions
- Hoover sign
common co-morbidities with FND
autism
EDS/hypermobility
chronic pain
there is abnormal activation of _____ & _____ with FND
supplemental motor area (motor plan)
right temporo-parietal junction (feedforward & self agency)
there is increased activity of _____ with FND
cingulate gyrus (self monitoring & motor inhibition)
what is the hallmark issue of FND?
misdirected attention (inability to habituate)
agency & attention issue are due to over-weighting of ______ signals combined with slowed and less acurate ____
over-weighted feedforward
slowed sensory processing & feedforward
brain areas for agency
temporo-parietal junction
prefrontal cortex
cerebellum
FND has ___mirror neuron activation
increased
sensory issues with FND
low registration
sensory sensitivity & avoiding
autonomic symptoms of FND
- low HRV
- increased resting HR
- abnormal biomarkers (increased cortisol & c-reactive protein)
- hyperactive startle
- increased arousal
key components of psychological approach to FND
- regain control
- change learned behaviors
- address underlying anxiety, depression, trauma
- understand self & emotional health
- tolerate & communicate emotions & stress
4 core areas of intervention for FND
- education
- retraining movement w/ diverted attention
- demo normal movement can occur
- change maladaptive behavior related to sx
goal directed rehab approach
focus on function
focus on task, not self
most common motor symptoms of FND
decreased balance
weakness
most common non-motor symptoms of FND
fatigue
somatosensory symptoms
cognitive symptoms
outcome measure important to FND
patient specific functional scale
FND treatment:
level 1 =
level 2 =
level 3 =
level 4 =
level 1 = SC & PNS
level 2 = brainstem
level 3 = hypothalamus
level 4 = limbic system
