• Clin Med (Lond) · Jan 2021

    Review

    A practical review of functional neurological disorder (FND) for the general physician.

    • Karina Bennett, Clare Diamond, Ingrid Hoeritzauer, Paula Gardiner, Laura McWhirter, Alan Carson, and Jon Stone.
    • Royal Infirmary of Edinburgh, Edinburgh, UK.
    • Clin Med (Lond). 2021 Jan 1; 21 (1): 283628-36.

    AbstractWe present a practical overview of functional neurological disorder (FND), its epidemiology, assessment and diagnosis, diagnostic pitfalls, treatment, aetiology and mechanism. We present an update on functional limb weakness, tremor, dystonia and other abnormal movements, dissociative seizures, functional cognitive symptoms and urinary retention, and 'scan-negative' cauda equina syndrome. The diagnosis of FND should rest on clear positive evidence, typically from a combination of physical signs on examination or the nature of seizures. In treatment of FND, clear communication of the diagnosis and the involvement of the multidisciplinary team is beneficial. We recommend that patients with FND are referred to specialists with expertise in neurological diagnosis. FND is a common presentation in emergency and acute medical settings and there are many practical elements to making a positive diagnosis and communication which are useful for all physicians to be familiar with.© Royal College of Physicians 2021. All rights reserved.

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