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Neurologists treat Functional Neurological Disorder (FND) using a combination of education, symptom-focused strategies, and referrals to appropriate therapies. Treatment varies by symptoms (motor, sensory, seizures, gait, speech, etc.), but the core approach is:
1. Clear Explanation and Education
A neurologist’s most important role is to:
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Explain that symptoms are real, common, and caused by dysfunction in how the brain sends/receives signals—not damage.
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Show positive exam signs (e.g., Hoover’s sign) to demonstrate reversibility.
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Reassure the patient that improvement is possible with proper therapy.
This reduces fear and helps engage in treatment.
2. Physical & Occupational Therapy (Front-line Treatment)
Neurologists often refer patients to FND-specific rehabilitation, which includes:
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Motor retraining / relearning movement
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Graded activity and normal movement patterns
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Balance and gait therapy
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Desensitization therapy for sensory symptoms
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Functional voice or speech retraining for speech-related FND
These therapies are structured differently from standard physical therapy and focus on retraining brain–body connection.
3. Psychological Therapies (If applicable)
Neurologists may refer patients to:
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Cognitive Behavioral Therapy (CBT) for FND
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Trauma-focused therapies (if PTSD or trauma contributes)
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Acceptance and Commitment Therapy (ACT)
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Psychodynamic therapy in some cases
Not because the symptoms are “in your head,” but because psychological tools help regulate pathways involved in FND.
4. Treatment of FND with Dissociative (Non-Epileptic) Seizures
For functional seizures, neurologists may recommend:
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CBT-based therapy specifically for dissociative seizures
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Education about seizure triggers
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Avoidance of unnecessary anti-epileptic drugs (since EEG is normal)
5. Management of Coexisting Conditions
Neurologists also treat or coordinate care for:
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Migraine
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Chronic pain
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Sleep disorders
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Anxiety or depression
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Autonomic symptoms (POTS, dizziness)
Managing these improves overall FND symptoms.
6. Medication
There is no drug that treats FND directly, but neurologists may prescribe medications for:
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Anxiety or mood disorders
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Chronic pain
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Sleep problems
But medication is usually supportive, not primary treatment.
7. Multidisciplinary Team Approach
The most effective FND programs involve:
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Neurologists
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FND-trained physiotherapists
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Psychologists/psychiatrists
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Occupational therapists
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Speech therapists
Summary
Neurologists treat FND using:
✔ Explanation and education
✔ Referral to specialized physical and psychological therapies
✔ Management of comorbid conditions
✔ Avoiding unnecessary medications/tests
✔ Coordinating multidisciplinary care
If you want, I can also explain:
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What treatment looks like specifically for functional movement symptoms,
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Functional seizures,
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Or functional sensory symptoms.
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