Friday, 28 November 2025

P FND MX BY NEUROLOGISTS

 A

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:

  • Explain that symptoms are real, common, and caused by dysfunction in how the brain sends/receives signals—not damage.

  • Show positive exam signs (e.g., Hoover’s sign) to demonstrate reversibility.

  • 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:

  • Motor retraining / relearning movement

  • Graded activity and normal movement patterns

  • Balance and gait therapy

  • Desensitization therapy for sensory symptoms

  • 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:

  • Cognitive Behavioral Therapy (CBT) for FND

  • Trauma-focused therapies (if PTSD or trauma contributes)

  • Acceptance and Commitment Therapy (ACT)

  • 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:

  • CBT-based therapy specifically for dissociative seizures

  • Education about seizure triggers

  • Avoidance of unnecessary anti-epileptic drugs (since EEG is normal)


5. Management of Coexisting Conditions

Neurologists also treat or coordinate care for:

  • Migraine

  • Chronic pain

  • Sleep disorders

  • Anxiety or depression

  • 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:

  • Anxiety or mood disorders

  • Chronic pain

  • Sleep problems

But medication is usually supportive, not primary treatment.


7. Multidisciplinary Team Approach

The most effective FND programs involve:

  • Neurologists

  • FND-trained physiotherapists

  • Psychologists/psychiatrists

  • Occupational therapists

  • 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:

  • What treatment looks like specifically for functional movement symptoms,

  • Functional seizures,

  • Or functional sensory symptoms.

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