Neurological Disorder Refers to a Range of Symptoms

Richard Rees^*
*Correspondence: Richard Rees, Department of Neurology, University of Sheffield, London, UK, Email:

Keywords

Neurological disorder • Physiological abnormalities • Cognitive impairments • Psychiatric assessment

Introduction

Functional Neurological Disorder refers to a range of symptoms that resemble those of neurological disorders but lack identifiable structural or physiological abnormalities. Symptoms can include movement disorders, seizures, sensory disturbances, and cognitive impairments. FND is a challenging condition, both for patients and healthcare professionals, as it requires a multifaceted approach that combines medical, psychological, and rehabilitative interventions. Despite the significant impact of FND, the education and training of healthcare professionals, especially neurologists, have historically placed less emphasis on functional disorders compared to organic neurological conditions. This knowledge gap often leads to misdiagnosis, inappropriate investigations, and delayed or ineffective treatments for patients with FND. By developing a dedicated curriculum for FND, neurology education can bridge this gap and ensure that future neurologists are proficient in diagnosing and managing this complex disorder. A comprehensive curriculum for FND should encompass various key components to provide a well-rounded education for neurologists [1].

Literature Review

Understanding the underlying mechanisms and contributing factors of FND is fundamental to accurate diagnosis and effective management. The curriculum should cover the neurobiological, psychosocial, and cultural factors that influence the development and presentation of FND. Diagnostic Skills and Assessment: Neurologists need to be adept at differentiating FND from organic neurological disorders. The curriculum should focus on clinical skills, including history-taking and physical examination techniques specific to FND. Additionally, training in the use and interpretation of appropriate diagnostic tests, such as neuroimaging and electrophysiological studies, can be incorporated. Managing FND requires a multidisciplinary approach involving neurologists, psychologists, psychiatrists, physiotherapists, occupational therapists, and other healthcare professionals. Given the close relationship between FND and mental health, the curriculum should address the psychiatric comorbidities commonly associated with FND. This includes educating neurologists on the role of psychological factors in symptom expression, providing knowledge of appropriate psychological interventions, and promoting the integration of mental health professionals into the care team [2].

Discussion

The curriculum should provide comprehensive training on rehabilitation techniques tailored to FND patients. This may involve physical therapy, occupational therapy, cognitive-behavioral therapy, and other evidencebased approaches. Practical skills related to educating patients about FND, setting realistic treatment goals, and providing ongoing support should also be included. FND raises unique ethical challenges for healthcare professionals. The curriculum should address ethical considerations such as patient autonomy, stigma and the potential for iatrogenic harm. Training in effective communication strategies and building therapeutic alliances with FND patients should be emphasized. comprehensive understanding of FND, neurologists will be better equipped to distinguish it from organic neurological conditions, leading to earlier and more accurate diagnoses. A curriculum dedicated to FND ensures that neurologists have the necessary skills and knowledge to provide appropriate care to FND patients. This can result in improved patient outcomes, increased patient satisfaction, and reduced healthcare costs associated with unnecessary investigations and interventions. Education about FND can help reduce the stigma often associated with the condition. By increasing awareness and understanding among neurologists, the curriculum can foster a more empathetic and supportive approach to patients with FND. A curriculum focused on FND can stimulate interest among neurology trainees in conducting research in this field. This can lead to advancements in our understanding of the disorder, development of innovative treatments, and improvements in patient care [3].

Developing a comprehensive curriculum for Functional Neurological Disorder in neurology education is essential to address the complex nature of this condition. By incorporating key components such as etiology, diagnostics, multidisciplinary management, psychological considerations, rehabilitation strategies, and ethical considerations, a dedicated curriculum can equip future neurologists with the necessary skills and knowledge to effectively diagnose and manage FND. Ultimately, this educational initiative has the potential to enhance patient care, reduce stigma, and advance research in the field of Functional Neurological Disorder. Functional Neurological Disorder is a common and often misunderstood condition characterized by neurological symptoms that cannot be explained by underlying organic pathology. FND poses a significant diagnostic and therapeutic challenge for neurologists worldwide. Given the increasing prevalence and impact of FND, it is crucial to develop a comprehensive curriculum that equips neurologists with the knowledge and skills needed to effectively diagnose and manage this complex disorder. This article explores the importance of developing a curriculum for FND within neurology training programs and outlines key components that should be included [4].

Functional Neurological Disorder is a term used to describe a wide range of neurological symptoms that are not attributable to a specific organic cause. Instead, these symptoms arise from altered or disrupted functioning of the nervous system. FND encompasses various manifestations, including motor symptoms sensory symptoms. It is crucial for neurologists to recognize the heterogeneity of FND and understand the underlying psychological and psychosocial factors that contribute to its development and perpetuation. Currently, many neurologists receive limited training in the diagnosis and management of FND. This knowledge gap can lead to misdiagnosis, delayed treatment, and unnecessary medical interventions for patients. FND can mimic other neurological conditions, making accurate diagnosis challenging. A specialized curriculum would enable neurologists to develop the necessary skills to differentiate FND from organic disorders accurately. It would also equip them with the knowledge of appropriate diagnostic tests and red flags that warrant further investigation. Managing FND often requires a multidisciplinary approach, involving psychiatrists, psychologists, physiotherapists, and other healthcare professionals. A curriculum in FND would foster collaboration among different specialties, emphasizing the importance of an integrated care model for patients with complex functional symptoms. Effective management of FND relies on a combination of pharmacological, psychological, and rehabilitative interventions. A curriculum would educate neurologists about evidence-based treatments, such as cognitive-behavioral therapy, physical therapy, and symptom-focused medications, enabling them to provide comprehensive care and improve patient outcomes [5].

FND is a condition that requires a compassionate and patient-centered approach. A curriculum in FND would emphasize the importance of effective communication, empathy, and shared decision-making, allowing neurologists to establish a therapeutic alliance with their patients and address their unique needs. Education on clinical features, diagnostic criteria, and differential diagnoses of FND. This should include training in the use of standardized assessment tools, the interpretation of neuroimaging studies, and the importance of a thorough neurological examination. Understanding the psychological factors that contribute to FND, including trauma, stress and comorbid psychiatric conditions. This section should cover the basics of psychiatric assessment, the use of psychotropic medications, and the principles of psychotherapy in FND management. Highlighting the importance of collaboration with other healthcare professionals involved in FND management, including psychiatrists, psychologists, physiotherapists, and occupational therapists. This section should provide guidelines on how to coordinate care effectively and engage in a team-based approach [6].

Conclusion

Training in effective communication skills, empathy, and the delivery of difficult diagnoses. Emphasizing the importance of shared decision-making, patient education, and long-term follow-up to foster a therapeutic alliance with patients. Developing a comprehensive curriculum for Functional Neurological Disorder within neurology training programs is imperative to address the diagnostic and therapeutic challenges associated with this complex condition. A specialized curriculum would equip neurologists with the knowledge and skills necessary to accurately diagnose and effectively manage FND, promoting better patient outcomes and reducing unnecessary medical interventions. By incorporating key components such as diagnostic approaches, multidisciplinary collaboration, therapeutic interventions, and patient-centered care, the curriculum can provide neurologists with a solid foundation to navigate the complexities of FND confidently. Ultimately, a well-rounded curriculum in FND will contribute to improved care and enhanced quality of life for individuals living with this condition. The curriculum should emphasize the importance of interdisciplinary collaboration and provide opportunities for trainees to engage in multidisciplinary clinics or case discussions.

Acknowledgement

None

Conflict of Interest

None

References

1. Li, Jiali, Jianmin Chen, Christopher L. Ricupero and Ronald P. Hart, et al. "Nuclear accumulation of HDAC4 in ATM deficiency promotes neurodegeneration in ataxia telangiectasia."Nat Med 18 (2012): 783-790.

Google Scholar, Crossref, Indexed at

2. Chen, Jianmin, Yanping Chen, Graham Vail and Heiman Chow, et al. "The impact of glutamine supplementation on the symptoms of ataxia-telangiectasia: a preclinical assessment."Mol Neurodegener 11 (2016): 1-14.

Google Scholar, Crossref, Indexed at

3. Campbell, Andrew, Jared Bushman, Joshua Munger and Mark Noble, et al. "Mutation of ataxia–telangiectasia mutated is associated with dysfunctional glutathione homeostasis in cerebellar astroglia."Glia64 (2016): 227-239.

Google Scholar, Crossref, Indexed at

4. Datta, S. Deblina, Amish Talwar and James T. Lee. "A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: Illness beyond acute infection and public health implications."JAMA324 (2020): 2251-2252.

Google Scholar, Crossref, Indexed at

5. Perez, Giraldo, Gina S., Sareen T. Ali and Anthony K. Kang, et al. "Neurologic Manifestations of Long COVID Differ Based on Acute COVID‐19 Severity."Ann Neurol(2023).

Google Scholar, Crossref, Indexed at

6. Michelen, Melina, Lakshmi Manoharan, Natalie Elkheir and Vincent Cheng, et al. "Characterising long COVID: A living systematic review."BMJ Glob Health 6 (2021): e005427.

Google Scholar, Crossref, Indexed at