Functional neurological disorders: the neurological assessment as treatment

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The neurologist's role in patients with functional disorders has traditionally been limited to making the diagnosis, excluding a 'disease' and pronouncing the symptoms to be 'non-organic' or 'psychogenic'. In this article, I argue that there are multiple opportunities during routine assessment of a patient with a functional disorder for the neurologist to take the lead with treatment. These opportunities occur throughout history taking, during the examination and, with greatest potential for treatment, at the end of the consultation. Elements of the neurologist's discussion that may be most useful include: (a) emphasis that symptoms are genuine, common and potentially reversible; (b) explanation of the positive nature of the diagnosis (i.e. not a diagnosis of exclusion); (c) simple advice about distraction techniques, self-help techniques and sources of information; (d) referral on to appropriate physiotherapy and/or psychological services; (e) offering outpatient review. I also discuss how new diagnostic criteria for DSM-5 and changes proposed for ICD-11 may facilitate changes that allow neurologists to bring their management of patients with functional disorders in line with other multidisciplinary neurological disorders in the outpatient clinic.

Original languageEnglish
Pages (from-to)363-73
Number of pages11
JournalClinical Neurophysiology
Volume44
Issue number4
DOIs
Publication statusPublished - Oct 2014

Fingerprint

Dive into the research topics of 'Functional neurological disorders: the neurological assessment as treatment'. Together they form a unique fingerprint.

Cite this