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  • The Diagnosis

    • ‘Acknowledgement of a need for closer collaboration between neurologist and psychiatrists is needed.’ ¹

    • ‘The underlying disease model has changed from a primarily psychological to a neurobiopsychosocial model’ ¹

    • ‘There are to date no official guidelines for the treatment of FMD [FND] and there continues to be a lack of prospective, randomized treatment trials.’ ¹

  • The Patient

    • ‘Chronic disability in FMD [FND] patients has been found to be comparable to patients with Parkinson’s Disease with even greater distress in quality of life and mental health measures.’ ¹

    • ‘Patients with psychogenic disorders in general, including those with FMD [FND], do not have the expected rates of psychological trauma, either at the onset of physical symptoms or in the past.’ ²

    • ‘There is a common occurrence of physical triggering events such as Illness or Injury prior to onset.’ ²

    • ‘FND is not commonly found in children and in the elderly.’ ²

    • ‘Most common symptoms are Tremors, dystonia, myoclonus, gait problems.’²

    • ‘The mean age at onset in different studies ranges from 37 to 50 years.’²

    • ‘Women are more often affected than men.’²

  • The Research

    • ‘The findings of lower activity in regions associated with motor preparation and greater activity in limbic structures during motor preparation reveal a possible mechanism of abnormal emotional processing interfering with normal motor planning.’¹

    • ‘The left SMA had lower functional connectivity with bilateral dorsolateral prefrontal cortex regions during internally versus externally generated movements, providing evidence for impaired top-down regulation of action selection.’¹

    • ‘Recent fMRI study revealed greater activity in limbic structures (right amygdala, left anterior insula and bilateral posterior cingulate area) and decreased activity in the left supplementary motor area (SMA) during a motor preparation task in FMD [FND] patients compared to controls.’¹

    • ‘… dystonia group showed abnormal increases in the primary motor cortex and thalamus compared with controls, with decreases in the cerebellum…’ ‘In contrast, the psychogenic dystonia group showed the opposite pattern, with abnormally increased blood flow in the cerebellum and basal ganglia, with decreases in the primary motor cortex.’ ‘Compared to the control group, both organic and functional Dystonia groups had abnormal blood flow in the brain.’³

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