ND II - FND

Functional Neurological Disorders (FND) is an umbrella term for a spectrum of disorders. Select the MOST COMMON disorders that fall under this umbrella.

• functional movement disorders (FMD)

• complex regional pain syndrome (CRPS)

• persistent postural-perceptual dizziness (PPPD)

• psychogenic/somatoform disorders

• conversion disorder

FND has a similar incidence to MS & ALS and is the second most common diagnosis in neurology clinics. Functional Neurological Disorders MOST OFTEN occur from

• physical event such as MVA or fall from height

• emotional event such as divorce

• in conjunction with previous psychiatric history

• focal neurological disease

• abnormal habitual movement that catastrophizes into dysfunction

What is the MOST APPROPRIATE definition of "agency" as it relates to hypervigilance and internal focus?

• neurological pain brought upon by presence of 2+ comorbidities

• abnormal habituation d/t impaired perception of self

• the experience of being the cause of our own actions

• predisposing and perpetuating factors contributing to brain network miscommunication

What are the MOST COMMON clinical signs of FND?

• whack-a-mole sign

• hoover sign

• hip abductor sign

• tonic contraction of mouth

• tonic contraction of neck

The following list of characteristics most accurately describes which neurological disorder?

variable presentation, entrainable, suppressible, sudden onset, occasional exacerbations and remissions

• Functional Neurological Disorder

• Nonfunctional Neurological Disorder

Which of the following criteria would indicate a patient is MOST LIKELY suitable for physical therapy?

• pt has a unambiguous diagnosis of FND

• pt is open in their diagnosis and willing to try physical therapy

• pt is unable to identify specific goals but rather desires improvement in their general function

• pt has additional comorbidities such as bipolar disorder

• pt has had a high level of satisfaction with care thus far in their diagnosis

What are the MOST APPROPRIATE treatment techniques for FND or any of the umbrella disorders?

• early weight bearing with progressively less limb support for noted UE/LE weakness

• confining the pt to a wheelchair post ambulation d/t their gait pattern impairments and high fall risk

• increase or decrease gait speed during ambulation in hopes to limit gait disturbances

• adjust habitual sitting and standing postures to less than end-range ROM to prevent fixed dystonia

• add a dual-task assignment during recumbent bike peddling (such as naming states or countries) in hopes to achieve full LE ROM while biking