Mastering the art: approaches to diagnosis and management of functional neurological disorders in Irish neurology

Functional Neurological disorder (FND) is a common, disabling condition which is often seen in Neurology Clinics. There are significant challenges associated with making the diagnosis accurately and efficiently, effectively communicating this to patients, and developing an approach to treatment. Significant progress has been made in this field in recent years leading to changes in approaches to diagnosis (positive signs, incongruity and inconsistency), communication (demonstration of signs to patients, a biopsychosocial formulation, and knowledge of aetiological factors), and therapy (physical therapy, psychotherapy, and multidisciplinary care.) In order to compare the current approach to the diagnosis and management of patients referred to Neurology and diagnosed with FND, a chart review was performed of patients referred to an Irish tertiary referral centre over a two year period who were given a diagnosis of FND. Diagnostic approach, communi- cation of the diagnosis, and referral for treatment were assessed against a standard derived from consensus statements. Additionally, a survey was performed gathering data from current Neurology trainees and consultant Neurologists in Ireland. This survey took the form of responses to clinical vignettes assessing approaches to the diagnosis and management of FND, questions regarding experience with FND and demographic data. Survey results were compared against a similar survey performed by one of the authors in 2014 to evaluate changes in practice over the past decade. The findings will be presented at conference.