Overview Papers

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Stone J, Burton C, Carson A (2020) Recognising and explaining functional neurological disorder. BMJ 371:m3745

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Espay AJ, Aybek S, Carson A, et al (2018) Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol 75:1132–1141.

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Ball HA, McWhirter L, Ballard C, et al (2020) Functional cognitive disorder: dementia's blind spot. Brain: 143:2895-2903. doi: 10.1093/brain/awaa224.

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Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;o64. http://dx.doi.org/10.1136/bmj.o64

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Explaining the Diagnosis

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Carson A, Lehn A, Ludwig L, Stone J (2016) Explaining functional disorders in the neurology clinic: a photo story. Pract Neurol 16:56–61.

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Adams C, Anderson J, Madva EN, LaFrance Jr WC, Perez DL (2018) You’ve made the diagnosis of functional neurological disorder: now what? Pract Neurol 18:323 LP – 330

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Stone J, Edwards MJ (2012) Trick or treat? Showing patients with functional (psychogenic) motor symptoms their physical signs. Neurology 79:282–284

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Physiotherapy

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Nielsen G, Stone J, Matthews A, et al (2015) Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry 86:1113–1119.

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Occupational Therapy

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Nicholson C, Edwards MJ, Carson AJ, et al (2020) Occupational therapy consensus recommendations for functional neurological disorder. J Neurol Neurosurg Psychiatry jnnp-2019-322281.

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Royal College of Occupational Therapists (2017) Embracing risk; enabling choice. Guidance for
occupational therapists This is a useful resource to guide clinical reasoning to facilitate supported
risk taking as part of rehabilitation (e.g. engaging in daily activities with less support from others).

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Speech & Language Therapy

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Baker J, Barnett C, Cavalli L, et al (2021) Management of functional communication, swallowing, cough and related disorders: Consensus recommendations for speech and language therapy. J Neurol Neurosurg Psychiatry 92:1112–1125

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Neuropsychiatry

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Perez DL, Aybek S, Popkirov S, et al (2020) A Review and Expert Opinion on the Neuropsychiatric Assessment of Motor Functional Neurological Disorders. J Neuropsychiatry Clin Neurosci appi.neuropsych.

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Treatment Resources

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A patient rehabilitation workbook, and other resources for clinicians, produced by FND Australia [fndaustralia.com.au]

http://fndaustralia.com.au/resources/clinical-tools.html

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Functional Movement Disorder

Textbook: LaFaver K, Maurer CW, Nicholson T, Perez DL (eds) Functional Movement Disorder:
An interdisciplinary case-based approach. Humana Press 2022.

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Evidence for Treatment

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Randomised Trials

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Goldstein LH, Robinson EJ, Mellers JDC, et al (2020) Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. The Lancet Psychiatry 7:491–505.

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Jordbru AA, Smedstad LM, Klungsøyr O, Martinsen EW (2014) Psychogenic gait disorder: A randomized controlled trial of physical rehabilitation with one-year follow-up. J Rehabil Med 46:181–187.

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Nielsen G, Buszewicz M, Stevenson F, Hunter R, Holt K, Dudziec M, Ricciardi L, Marsden J, Joyce E, Edwards M (2017) Randomised feasibility study of physiotherapy for patients with functional motor symptoms. J Neurol Neurosurg Psychiatry 88:484–490.
 

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Cohort Studies

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Czarnecki K, Thompson JM, Seime R, Geda YE, Duffy JR, Ahlskog JE (2012) Functional movement disorders: successful treatment with a physical therapy rehabilitation protocol. Park Relat Disord 18:247–251

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Demartini B, Batla A, Petrochilos P, Fisher L, Edwards MJ, Joyce E (2014) Multidisciplinary treatment for functional neurological symptoms: a prospective study. J Neurol 261:2370–2377.

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Demartini B, Bombieri F, Goeta D, Gambini O, Ricciardi L, Tinazzi M (2020) A physical therapy programme for functional motor symptoms: A telemedicine pilot study. Park Relat Disord 76:108–111

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Jacob AE, Kaelin DL, Roach AR, Ziegler CH, LaFaver K (2018) Motor Retraining (MoRe) for Functional Movement Disorders: Outcomes From a 1-Week Multidisciplinary Rehabilitation Program. PM R 10:1164–1172.

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Maggio JB, Ospina JP, Callahan J, Hunt AL, Stephen CD, Perez DL (2020) Outpatient Physical Therapy for Functional Neurological Disorder: A Preliminary Feasibility and Naturalistic Outcome Study in a U.S. Cohort. J Neuropsychiatry Clin Neurosci 32:85–89.

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McCormack R, Moriarty J, Mellers JD, Shotbolt P, Pastena R, Landes N, Goldstein L, Fleminger S, David AS (2013) Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study. J Neurol Neurosurg Psychiatry 85:895–900.

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Petrochilos P, Elmalem MS, Patel D, Louissaint H, Hayward K, Ranu J, Selai C (2020) Outcomes of a 5-week individualised MDT outpatient (day-patient) treatment programme for functional neurological symptom disorder (FNSD). J Neurol 267:2655–2666.

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Nielsen G, Ricciardi L, Demartini B, Hunter R, Joyce E, Edwards MJ (2015) Outcomes of a 5-day physiotherapy programme for functional (psychogenic) motor disorders. J Neurol 262:674–81.

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Systematic Review (Psychotherapy)

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Gutkin M, McLean L, Brown R, Kanaan R (2020) Systematic review of psychotherapy for adults with functional neurological disorder. J Neurol  Neurosurg Psychiatry. Online first. doi: 10.1136/jnnp-2019-321926

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Outcome Measures

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Nicholson T, Carson A, Edwards MJ, et al (2020) Outcome measures for functional neurological (conversion) disorder. A review of the theoretical complexities. J. Neurol. Clin. Neurosci. online first.

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Pick S, Anderson DG, Asadi-Pooya AA, et al (2020) Outcome measurement in functional neurological disorder: a systematic review and recommendations. J Neurol Neurosurg Psychiatry jnnp-2019-322180.

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The Costs of FND

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Stephen CD, Fung V, Lungu CI, Espay AJ (2020) Assessment of Emergency Department and Inpatient Use and Costs in Adult and Pediatric Functional Neurological Disorders. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2020.3753

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O’Mahony B, Nielsen G, Baxendale S, Edwards MJ, Yogarajah M. Economic Cost of Functional Neurologic Disorders: A Systematic Review. Neurology. 2023;101(2):e202–14. 

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Optimal clinical pathway for adults with FND

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An exemplar optimal clinical pathway for adults with FND. Produced by the National Neurosciences Advisory Group, together with patient charities and expert clinicians. Link to website.  Link to document.

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NHS Scotland, Centre for Sustainable Delivery, Modernising Patient Pathways Programme:
Functional Neurological Disorder National Pathway. Link to website

https://nhscfsd.co.uk/media/zt0h0s0k/fnd-national-pathway-final-16-may-2024.pdf

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Interesting Articles in the General Media

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Decoding a Disorder at the Interface of Mind and Brain. Scientific American. 1 November 2020.

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