Functional neurological disorder

Functional Neurological Disorder (FND) is the diagnostic label for presentation of neurological symptoms without underlying causal organic injury. It can occur in isolation or alongside organic injury, and research reports around one in six people presenting to neurological clinics have functional symptoms. Understanding of the presentation has evolved through multiple labels and approaches. The evidence presented for therapeutic work with this group summarises current guidance relevant to SLTs and the ABI caseload together with models to assist the working clinician with theory behind FND. The discussion of assessment and treatment relies on international consensus guidance regarding effective approaches. Successful treatment incorporates focus on individual’s health beliefs and understanding of their positive diagnosis with FND. This chapter highlights how the symptom-based model applies to different SLT neurological symptoms (e.g. language, voice, dysphagia) and also considers the practicalities of clinical differential between functional symptoms and other presentations. The worked example in this chapter discusses a service user with voice symptoms. It presents the initial assessment notes and examples of symptom observation which led to a diagnosis of functional overlay, therapeutic approach used and outcomes gained.