From the Guidelines
Treatment for Functional Neurological Disorder (FND) should be based on a biopsychosocial aetiological framework, incorporating education, rehabilitation within functional activity, and self-management strategies.
Key Principles of Treatment
- Education: Provide education about the diagnosis and symptoms of FND to the patient and their significant others 1
- Rehabilitation: Focus on activity-based (functional) rather than impairment-based goals and interventions, and integrate specific treatment techniques into function 1
- Self-management: Introduce the concept of self-management at initial assessment and complete a relapse prevention and ongoing self-management plan as part of treatment 1
Role of Occupational Therapy
- Occupational therapists have an integral role in the multidisciplinary management of people with FND, and their treatment should be based on a biopsychosocial aetiological framework 1
- Occupational therapy interventions for FND may include retraining normal movement within function, graded reintroduction to daily activities, anxiety management, and the reestablishment of structure and routine 1
Role of Speech and Language Therapy
- Speech and language therapy for FND should address illness beliefs, self-directed attention, and abnormal movement patterns through a process of education, symptomatic treatment, and cognitive behavioural therapy within a supportive therapeutic environment 1
From the Research
Treatment Approaches for Functional Neurological Disorder (FND)
The treatment for FND typically involves a multidisciplinary approach, incorporating both rehabilitative therapies and psychological therapies. Some of the key treatment approaches include:
- Rehabilitative interventions, such as physical and occupational therapy, which are considered treatments of choice for functional motor symptoms 2, 3
- Psychotherapy, which is an emerging evidence-based treatment across FND subtypes 4, 3
- Cognitive behavioral therapy (CBT), which has been shown to be an effective intervention for FND 4
- Non-invasive brain stimulation techniques (NIBS), such as neurostimulation, which may also represent an effective therapeutic option for patients with FND 4
Key Principles of FND Treatment
The treatment of FND should be guided by the following key principles:
- A patient-centered perspective, emphasizing the importance of respectful communication and comprehensive explanation of the diagnosis to patients 2, 5
- A biopsychosocially-informed treatment plan, taking into account the complex interplay of biological, psychological, and social factors that contribute to FND 2, 5
- The involvement of a multidisciplinary team, including specialists with expertise in neurological diagnosis and treatment 2, 6
Future Directions for FND Treatment
Despite the advances that have been made in the treatment of FND, there is still a need for further research to optimize therapeutic approaches and develop novel interventions for patients who do not respond to currently available treatments 2, 4, 5, 3. This may involve the development of new treatments, such as NIBS, or the refinement of existing treatments to better meet the needs of individual patients.