Advanced Course for the Assessment & Management of Functional Neurological Disorder 

Program

Course Directors: Dara Albert, Alex Lehn, Sarah Lidstone, David Perez

 

Expert Panels

The Advanced Course chairs organized a webinar comprised of two panel discussions featuring expert speakers in FND. Speakers and panel topics are detailed below.

Moderator:

Barbara Dworetzky, MD
Professor of Neurology
Mass General Brigham
Harvard Medical School

Panel 1: How to put FND on the map locally and nationally: lessons learned

Guilhem Carle-Toulemonde, MD, MSc
Psychiatrist
Neuropsychiatry & consultation-liaison psychiatry
Saint-Exupery Clinic, France

Chrisma Pretorius, PhD
Associate Professor
Department of Psychology, Faculty of Arts and Social Sciences
Stellenbosch University

Gang Wang, MD, PhD
Professor, Attending Neurologist
Chair of the Department of Neurology
Renji Hospital affiliated Medical School of Shanghai Jiao Tong University

Michele Tinazzi, MD, PhD
Chief of Neurology
Department of Neurosciences, Biomedicine and Movement
University of Verona
 

Panel 2: Tips for Managing a Growing FND Clinical Service

Beatrice Garcin, MD, PhD
Professor
FND Multidisciplinary Unit
Assistance Publique Hopitaux de Paris

Dara Albert, DO, MEd
Child Neurologist
Nationwide Children's Hospital
The Ohio State University

Guilhem Carle-Toulemonde, MD, MSc
Psychiatrist
Neuropsychiatry & consultation-liaison psychiatry
Saint-Exupery Clinic, France

Gabriela Gilmour, MD, FRCPC
Movement Disorders Neurologist
Clinical Assistant Professor
University of Calgary

 

 

Recorded Lectures:

 

1. Diagnostic Pitfalls in FND 

33 minutes
 

Lecture Description

This session will deal with the limitations of diagnosis in FND. The ways in which we make a diagnosis appear reliable on a population level, but have many pitfalls on an individual case level. This talk will discuss the limitations both clinically and in our research evidence for the clinical signs that we have, and how to use them as safely as possible. Professor Stone will also discuss why some patients with FND are missed in clinical practice, and conversely, how we need to guard against overdiagnosis of FND, especially for people with mild symptoms, or where other issues, such as pain or fatigue, are dominant.

Learning Objectives

1. Learn more about the LIMITATIONS OF DIAGNOSTIC SIGNS that we have in FND and how to use them cautiously in clinical practice.
2. Become more aware of the issue of UNDERDIAGNOSIS of FND and the settings in which this happens.
3. Become more aware of the issue of OVERDIAGNOSIS of FND and the reasons why this commonly happens.

Jon Stone, MB, ChB, FRCP, PhD
Professor of Neurology
FNDS President Elect
University of Edinburgh

 

 

2. Functional Cognitive Disorder: Internal Inconsistency & Its Differentiation from Other Conditions 

35 minutes
 

Lecture Description

This session starts by briefly recapping the basics of current FCD criteria and mechanisms. Next, internal inconsistency examples, including measured, observed, and subjective functioning as well as current limitations, are discussed at length. A second major area of focus is differentiating FCD within the context of other FND symptoms, degenerative conditions, and other psychiatric presentations. Lastly, based on FCD and overall psychiatric conceptualization, suggestions are made regarding incorporating FCD-specific recommendations.

Learning Objectives

1. Describe 3 examples of internal inconsistency in FCD
2. Describe when to diagnose FCD in the presence of other FND features
3. Describe features to distinguish between FCD and neurodegenerative conditions

Erica Cotton, PsyD
Neuropsychologist
Assistant Professor in the Departments of Neurology and Psychiatry
Northwestern University

 

 

3. Neuropsychiatric Differential for FND

53 minutes
 

Lecture Description

This presentation is divided into two key themes about PPPD.  The first part is a review of clinical management that includes focuses on frequently encountered, but incompletely understood, problems in the differential diagnosis, followed by an update on best practices for treating the disorder. The second part is an update on potential mechanisms, bringing together data about alterations in space and motion perception, gait and gaze control, and brain activity and connectivity into a comprehensive model of factors that initiate and sustain the illness.

Learning Objectives

1. Improve accuracy in diagnosing PPPD​ by having an increased awareness of frequently encountered but incompletely resolved problems​ in its differential diagnosis.
2. Comprehend expected therapeutic outcomes when using the best practices to implement currently available treatments for PPPD.
3. Describe a comprehensive model of likely pathophysiological mechanisms underlying PPPD.

Jeffrey Staab, MD, MS
Professor and Chair
Department of Psychiatry and Psychology
Mayo Clinic

 

 

4. FND, Joint Hypermobility, & Chronic Pain: Diagnostic & Therapeutic Implications

37 minutes
 

Lecture Description

This session will explore two common comorbidities in FND; joint hypermobility and chronic pain.  The session will explain why joint hypermobility can be a risk factor for FND and provide advice about how to navigate this when diagnosing and treating FND. The session also covers how chronic pain differs from acute pain, including the peripheral and central mechanisms of pain. New work on neuroplastic/nociplastic pain provides some hope and guidance on how to treat this alongside FND.

Learning Objectives

1. To be able to explain how joint hypermobility may be a risk factor for FND
2. Recognize differences between acute and chronic pain and peripheral and central drivers for pain
3. To have some advice for patients about how to manage FND alongside these comorbidities

Ingrid Hoeritzauer, MBBCh, PhD
Consultant Neurologist
NHS Lothian
University of Edinburgh

 

 

5. Psychotherapeutic Considerations in FND for the Non-Psychotherapist

21 minutes
 

Lecture Description

The overall purpose of this activity is to enable the learner (non-psychotherapists) to incorporate psychotherapeutic strategies into their care of patients with functional neurological disorder. This will include a discussion of diagnostic understanding and acceptance in FND, establishment of rapport and boundaries, awareness of self and patient thoughts and emotions, and various forms of psychotherapy that can be helpful in FND.

Learning Objectives

1. Summarize important factors in psychotherapeutic engagement
2. Assess for the presence and absence of these factors in your patient encounters
3. Implement these factors in your patient encounters

Alison Buchholz, PhD
Assistant Professor
Johns Hopkins University
School of Medicine

 

 

6. Digital Health Care for FND

35 minutes
 

Lecture Description

In this lecture, Professor Carson will describe the various digital approaches to treatment in FND, including the advantages and disadvantages of each format. He will discuss the likely efficacy of such treatments and how they might be integrated into clinical practice. Professor Carson will discuss the difference between guided and standalone treatments. Lastly, he will discuss trial methodology so the listener can critically appraise reports of further developments. 

Learning Objectives

1. Understand the different types of digital provision
2. Understand the methodological complexity of delivering psychotherapy in a digital format
3. Understand trial methodology - advantages and disadvantages so that one knows what to look for when critically appraising evidence in one's daily practice

Alan Carson, MBChB, MPhil, MD, FRCPsych, FRCP
Consultant Neuropsychiatrist
Honorary Professor in Neuropsychiatry
NHS Lothian, University of Edinburgh

 

 

7. Triaging Treatment Recommendations for Functional Movement Disorder

31 minutes
 

Lecture Description

This lecture focuses on how to bridge the gap between diagnosis and starting treatment: triage and treatment planning. A dedicated assessment is needed to determine if a patient is ready to engage in therapy in FMD, and there are identifiable factors that indicate if it is a good time, or not the time, to begin treatment. Neuropsychiatric phenotyping can give clues about potential treatment targets and what techniques may or may not be helpful.

Learning Objectives

1. Understand why a rehab model is necessary in FMD/FND
2. Identify the red and green flags for engagement 
3. Recognize how neuropsychiatric phenotyping can help with treatment planning

Sarah Lidstone, MD, PhD
Director of the Integrated Movement Disorders Program
Toronto Rehabilitation Institute
Assistant Professor of Neurology, University of Toronto

 

 

8. Assessment and Management of FND in Children with Developmental Disabilities

36 minutes
 

Lecture Description

This presentation will explore the overlap between neurodevelopmental disorders, such as autism spectrum disorder and intellectual disability disorder, and functional neurological disorders. Dr. Albert will discuss the epidemiology, potential pathophysiological underpinnings, and treatment approaches.

Learning Objectives

1. Review the epidemiology of FND in children with and without developmental disabilities
2. Discuss the overlap between developmental disabilities, including autism spectrum disorder, and FND
3. Discuss special considerations for management in the children with developmental disabilities

Dara Albert, DO, MEd
Child Neurologist
Nationwide Children's Hospital
The Ohio State University

 

 

9. Spotlight on FND Care in Asia and Oceania: Regional and Cultural Considerations

37 minutes
 

Lecture Description

Functional Neurological Disorder (FND) is a common condition worldwide, with unique challenges across Asia and Oceania. This session highlights regional differences in training, education, and access to care, and explores how cultural beliefs and healthcare structures influence management. We discuss strategies to improve awareness, education, and multidisciplinary collaboration. Participants will gain practical insights into culturally sensitive communication and service development to enhance FND care in diverse settings.

Learning Objectives

1. Recognize regional differences in the presentation, diagnosis, and management of Functional Neurological Disorders (FND) across Asia and Oceania.
2. Identify key barriers and facilitators to effective FND care within diverse cultural and healthcare settings.
3. Apply practical strategies to improve FND education, communication, and multidisciplinary collaboration.

Alex Lehn, MD
Neurologist
Associate Professor
Princess Alexandra Hospital

Izyan Helmi, MB, BCh, BAO
Consultant Neurologist
Hospital Tuanku Jaafar Seremban
 

 

 

10. Understanding and Contextualizing Treatment Trajectories in Functional Neurological Disorder

42 minutes
 

Lecture Description

In this talk, Dr. Perez will first highlight some of the large, published cohort studies identifying predictors of clinical outcomes in functional neurological disorder. Thereafter, the importance of the biopsychosocial formulation for initial treatment planning and longitudinal management will be emphasized. Lastly, this session will discuss several commonly encountered, yet often under-appreciated, clinical scenarios that can impact the longitudinal course of care in patients with functional neurological disorder.

Learning Objectives

1. To explain the literature on predictors of clinical outcome in functional neurological disorder. 
2. To explain the use of the biopsychosocial formulation for functional neurological disorder across the continuum of care.
3. To explain how there is a neurologic and psychiatric differential diagnosis for functional neurological disorder.

David Perez, MD, MMSc
Associate Professor of Neurology & Psychiatry
Harvard Medical School
Mass General Brigham Departments of Neurology and Psychiatry

 

 

11. Bringing Mechanistic Understandings of FND to the Clinics

33 minutes
 

Lecture Description

This talk will contextualize the latest neuroscientific findings implicated in FND - with a focus on the implications of these findings as they relate to commonly encountered clinical scenarios in FND care. 

Learning Objectives

1. Observe the main results of recent research studies addressing brain dysfunction in FND 
2. Recognize the advances made in understanding the pathophysiology of FND
3. Utilize these concepts in clinic when explaining the disorder to patients

Selma Aybek, MD
Professor of Neurology
Consultant Neurologist
Fribourg University

 

 

12. Medicolegal and Disability Considerations in FND

19 minutes
 

Lecture Description

This session provides an accessible introduction to the medicolegal and disability considerations surrounding FND. Attendees will gain a broad overview of issues such as FND's impact in legal and disability contexts, and the challenges clinicians face when assessing and reporting on functional impairment. Designed for clinicians and professionals new to the medicolegal aspects of FND, this session sets the stage for deeper exploration and discussion.

Learning Objectives

1. Understand the prevalence and medicolegal relevance of FND
2. Apply structured assessment and reporting focused on function
3. Anticipate prognosis and address common medicolegal disputes

Evan Lewis, MD, FRCPC, CSCN EEG Diplomate, CMLE, C-CAT(P)
Neurologist 
Adjunct Assistant Professor
North Toronto Neurology

 

 

13. FND & Other Co-Occurring Neurological Disorders

35 minutes
 

Lecture Description

There is increasing recognition that functional neurological disorders (FNDs) often co-occur with other neurological conditions, but this overlap is frequently overlooked. This session will examine the prevalence and timing of FNDs as a comorbidity to other neurological diseases, presenting a decisive diagnostic approach that emphasizes practical bedside signs and structured reasoning, supported by video case examples. Key condition-specific clinical patterns, including those related to movement disorders, multiple sclerosis, epilepsy, migraine, etc., will also be highlighted.

Learning Objectives

1. Summarize how often and at what stages FND co-occurs with major neurological disorders (epilepsy, movement disorders, multiple sclerosis, migraine, etc.) and recognize clinical patterns that should raise suspicion
2. Describe the importance and consequences of the correct identification of a co-occurring FND in a patient with another neurological condition
3. Identify positive signs supporting comorbid FND in a patient with another neurological condition and distinguish them from organic patterns at the bedside

Yury Seliverstov, MD, PhD
Neurologist
Clinical Researcher
University Clinic of Ulm