Functional neurological disorder: Practical management

Functional Neurological Disorder (FND) is a common and disabling condition seen by nearly every clinician in nearly every clinical setting. There are multiple subtypes with seizure and motor/movement being the most common. There is high health care utilization and costs, and many patients have a chronic course and remain disabled. It is clear from research over the past two decades that abnormalities in brain network activity are implicated in the pathophysiology of FND. Diagnosis requires positive criteria and knowing how to obtain a good history and avoid common pitfalls. There are evidence-based treatments and expert consensus recommendations. A multidisciplinary team knowledgeable about the disorder is important for the best outcomes but there is much more work to be done. This review will focus on the practical aspects of diagnosing and managing FND.