Our conclusions. @fndhope.bsky.social, FND action and @fndsociety.bsky.social

FND treatment is multidisciplinary, but there are barriers to care. Here are some thoughts on those. 5/

Physio for functional movement disorder has important differences to physio for other conditions in neurological practice

Thanks to Glenn Nielsen for this material . Workbooks and Therapist manuals from the Physio4FMD trial are free to download via www.physio4fmd.org/publications
4/

Dont just diagnose - formulate.

An example of a formulation based on Oliver Sacks autobiographical book 'A Leg to Stand on'. 3/

jnnp-bmj-com.eux.idm.oclc.org/content/83/9...

Some ideas for communication and explanation of functional movement disorder 2/

We can't be complacent. Most people with FND around the world still have terrible experiences of health care. But things are changing.. END.
bsky.app/profile/jons...

✅FND a core topic in UK and European Neurology training curricula
✅ New Co-ordinating Scientific Panel for FND in
@ean.org
bit.ly/3IvLD5Q
✅Functional seizure guidelines nearing publication. @aanmember.bsky.social . bit.ly/4nCtlyB. 5/

The optimum pathway for FND published by NHS England (2023) 4/

t.co/48lwfuzM1Y

This sits alongside other recent examples of national pathways and representation for FND:

The Scottish NHS FND pathway (2024) 3/

rightdecisions.scot.nhs.uk/neurology-pa...

It emphasises
✅Careful diagnosis and explanation
✅Follow-up appointments
✅Access to a multidisciplinary assessment and treatment team for all people with FND.
✅FND specialist clinics and more intensive rehab where appropriate. 2/

We hope this article stimulates research in this area. Id like to thank Jan Coebergh for starting this paper, ‪@timnicholson.bsky.social, Matt Butler, Lujain Khoja and David Dodick
Join @fndsociety.bsky.social to see the lecture I gave on this at Verona - END/

We especially acknowledge prior work looking at vestibular migraine and PPPD (pubmed.ncbi.nlm.nih.gov/38137140/_ ) which we didn’t cover, as well as a paper looking at functional seizures and migraine (pubmed.ncbi.nlm.nih.gov/37717461/ )10/

Take home clinical messages
➡️Look for and treat migraine in FND – a treatable comorbidity
➡️In people with migraine aura >24 hours – consider “FND symptoms triggered by migraine” and use FND focused therapy 9/

This matters because of increasing experience that FND-focused physiotherapy may be preferable to standard therapy 8/
x.com/GNielsen_Phy...

Migraine, especially migraine aura can definitely trigger FND, especially motor symptoms.

Aura that lasts longer than 24hrs, and certainly more than 72hrs may well be FND related 7/