Inpatient Advanced Clinical Focus Session: Functional Neurologic Disorders: Inpatient Management-Session Recording

Video Transcription

Video Summary

In this comprehensive session, Dr. Daniel Goodman and a colleague discuss Functional Neurologic Disorder (FND), commonly referred to as conversion disorder, and the distinctions necessary in diagnosing and treating it. The presentation describes FND's categorization under somatoform disorders as a condition characterized by symptoms that are incompatible with known neurological diseases but are genuine and respond well to rehabilitation interventions.<br /><br />The speakers emphasize the importance of interdisciplinary collaboration to manage FND, involving medical doctors, therapists, and ideally, psychologists. This approach includes consistently assessing symptoms for inconsistencies, distractibility, and variability, hallmarks of FND that differentiate it from other neurological conditions. They underline the unfortunately common misdiagnosis of FND and the essential differentiation needed from conditions such as factitious disorder or malingering.<br /><br />Furthermore, FND treatment through rehabilitation protocols aims to reset motor skills, mitigate symptoms via cognitive-behavioral therapy, and educate patients about symptom management to avoid unnecessary healthcare visits. Strategies include encouraging automatic movements, employing resets during therapy, and addressing psychological factors, like catastrophizing behaviors.<br /><br />Challenges discussed include insurance coverage for inpatient rehabilitation, particularly without a concurrent medical diagnosis, and managing patient expectations and family involvement in rehabilitation. Though TMS isn't employed in their practice, the team mainly advises conventional CBT interventions. Effective communication about FND with patients, especially those with co-existing psychiatric disorders, remains an integral yet challenging part of the process to foster understanding and recovery.<br /><br />The presentation closes with resources for further understanding and managing FND, highlighting the need for continued education and supportive patient environments.

Keywords

Functional Neurologic Disorder

conversion disorder

somatoform disorders

interdisciplinary collaboration

misdiagnosis

cognitive-behavioral therapy

rehabilitation protocols

symptom management

insurance coverage

patient education

psychiatric disorders