From the Guidelines
The recommended treatment approach for Functional Neurological Disorder (FND) is a multidisciplinary and individualized approach, focusing on education, physical rehabilitation, and psychological therapy, as outlined in the occupational therapy consensus recommendations 1.
Key Components of Treatment
- Education about the diagnosis and symptoms, emphasizing the potential for recovery and the importance of self-management strategies 1
- Physical rehabilitation, particularly specialized physiotherapy targeting specific functional symptoms, such as weakness, tremor, or gait disturbances 1
- Cognitive behavioral therapy (CBT) to address underlying psychological factors and develop coping strategies 1
- Psychotherapy to help patients understand emotional triggers and process past trauma when relevant
- Medications, such as antidepressants, may be used to address comorbid conditions like depression, anxiety, or pain, but are not first-line treatments 1
Principles of Intervention
- Be empathic and recognize that FND is a real and disabling condition 1
- Take the time to listen to the person’s story and build therapeutic rapport 1
- Agree treatment parameters at the start of intervention and introduce the concept of self-management at initial assessment 1
- Focus on activity-based (functional) rather than impairment-based goals and interventions 1
- Complete a relapse prevention and ongoing self-management plan as part of treatment 1
Treatment Approach
A biopsychosocial aetiological framework should guide occupational therapy treatment for FND, with education, rehabilitation within functional activity, and the use of taught self-management strategies being central to intervention 1. Treatment duration varies widely, typically ranging from weeks to months, with regular follow-up appointments to monitor progress. The effectiveness of this approach stems from its ability to address both the neurological manifestations and psychological factors that contribute to symptom development and maintenance, while promoting neuroplasticity through retraining movement patterns and cognitive processes.
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 interventions.
- Rehabilitative therapies, such as physical therapy, occupational therapy, and speech and language therapy, are often used to address motor symptoms and improve functional abilities 2, 3.
- Psychological therapies, including psychotherapy, are also effective in treating FND, particularly for patients with seizure-type symptoms or those who do not respond to rehabilitative therapies alone 3, 4.
Key Considerations for Treatment
When developing a treatment plan for FND, several factors should be considered:
- Early diagnosis and intervention are crucial to promote recovery and prevent long-term disability 3, 5.
- A patient-centered approach, taking into account the individual's specific needs and circumstances, is essential for effective treatment 2.
- The timing and combination of therapeutic interventions should be carefully planned to optimize outcomes 2, 3.
- Multidisciplinary teams, involving healthcare professionals from various disciplines, can provide comprehensive care and support for patients with FND 2, 6.
Treatment Outcomes and Future Directions
While many patients with FND respond well to treatment, some may not improve or may experience relapses 3, 5.