DR MATTHEW PHILLIPS (WAIKATO, NZ) ON FUNCTIONAL NEUROLOGICAL DISORDERS

 

11,683 views Nov 9, 2024

This presentation was made for medical students and junior doctors on Functional Neurological Disorders (FND) - one of the oldest, most misunderstood, and challenging areas in neurology. I would like to be clear - these conditions are complex, not easy to diagnose, and we still have much to learn. FND should never be used as a diagnosis of exclusion or a way to dismiss patients. A thorough workup to identify potential co-existing structural or metabolic problems is essential. Many of the most complex patients have both FND features and underlying structural, metabolic, or other organic issues - missing these is a serious mistake. When I refer to CFS, fibromyalgia, IBS etc. as “cousins” of FND, I simply mean that they frequently overlap and may share elements of abnormal brain processing (predictive perception of internal signals). This does not mean they are the same as FND, nor that they are purely or mainly psychological. Both structural and metabolic factors can play important roles, sometimes triggered by - or triggering - brain processing changes. The direction of causality likely varies between individuals. This needs more research. Last, helping people with these disorders can be very rewarding when done carefully and individually. References are on the final slide. For more on predictive processing in the brain, see: “The Integrative Brain: Functional Units in Predictive Processing” https://t.co/CmHLPJhYWv Sincere regards, Matt.