Explanation as treatment for functional neurologic disorders

Area of Science:

• Neurology
• Psychiatry
• Communication Studies

Background:

• Functional neurologic disorders (FND) present diagnostic challenges.
• Communication of the FND diagnosis significantly impacts treatment effectiveness.
• Disagreements in communication strategies often stem from theoretical models rather than evidence.

Purpose of the Study:

• To discuss barriers to effective FND diagnosis and communication.
• To explore different models for explaining FND diagnoses.
• To review evidence on the importance of communication in FND, particularly movement disorders and dissociative seizures.

Main Methods:

• Literature review and synthesis of existing evidence and expert opinions.
• Analysis of theoretical models influencing diagnostic communication.
• Identification of consensus components in effective FND explanation.

Main Results:

• Effective communication involves patient validation, a clear diagnostic label, and explaining symptom origins.
• Emphasis on symptom reversibility, rather than damage, is crucial.
• A consensus exists on several generic components of effective FND diagnosis communication.

Conclusions:

• Effective communication is a cornerstone of FND treatment, facilitating other therapies.
• Further research is needed to compare the efficacy of different explanatory models (e.g., functional vs. psychological).
• Key elements of effective communication include empathy, clear explanation, and appropriate referral pathways.