Functional Neurological Disorder (FND) rehabilitation service

Functional Neurological Disorder (FND) encompasses symptoms seemingly manifested through the neurological system but which are not caused by a physical neurological disease.

We view the mind and body as working in an integrated way which is reflected in our treatment approach.

Neuropsychiatry is ideally placed at the interface of Neurology and Psychiatry to create and deliver treatment programmes which integrate physical, behavioural and psychological factors relevant to the development of FND.

We look at both the symptoms and the narrative around symptoms which are important elements in the causation of the disorder. We look at precipitants and triggers to symptoms and perpetuating factors that may maintain them. We aim to address both. Sometimes, predisposing factors are important and our approach may raise awareness of the role these may play. Where co-morbid conditions play a prominent role, we may make suggestions as to how these could be explored.

The aim of our approach is to provide education and therapies which facilitate self-management. Individuals are guided to better understand their symptoms and to develop their own skills to manage, reduce and eventually in some cases, resolve them.

At present the approaches we use initially involve a combination of consultation and education. Further approaches include cognitive behavioural therapy, occupational therapy, physiotherapy focused on movement re-training and nursing interventions. These may be delivered remotely, face to face, in groups, in individualised multidisciplinary programmes within outpatient settings or inpatient environments. We also provide specialist support and advice to our community partners in North Central London (NCL).

Therapeutic approaches

For referrals that are accepted, patients will be reviewed in a Multi-Disciplinary Team (MDT) assessment clinic. This is to consider what approach may best suit an individual. We run education seminars to improve insight and understanding into FND. We also provide neuropsychiatric consultation, outpatient cognitive behavioural therapy and multidisciplinary programmes that combine cognitive behavioural therapy, occupational therapy, physiotherapy including for movement re-training, nursing and psychiatry.

FND Patient Self-Help Videos

We have developed some useful FND self-help videos for patients. In these videos, we review some of the key points to help manage functional movement disorders by implementing practical strategies.