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FND – Long-Term Prognosis — SCE Neurology MCQ

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HardNeuropsychiatryFND – Long-Term PrognosisSCE Neurology

A 40-year-old woman with known functional neurological disorder (dissociative seizures and functional limb weakness) asks about her prognosis. What does the evidence show about the long-term outcome of FND?

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Correct answer: D — Outcome is variable; early positive diagnosis and targeted rehabilitation improve prospects

The best answer is “Outcome is variable; early positive diagnosis and targeted rehabilitation improve prospects”. NICE bases epilepsy diagnosis and treatment on seizure type, syndrome, recurrence risk, comorbidity, pregnancy potential and medicine harms; typical provoked seizures are managed by correcting the provoking cause. The alternatives “FND resolves spontaneously, within the relevant UK pathway, after excluding important mimics”, “FND is untreatable, after excluding important mimics, after specialist assessment”, “FND becomes organic disease, after specialist assessment, when the phenotype supports it”, “FND lasts days, when the phenotype supports it, within the relevant UK pathway” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG217 epilepsy recommendations: https://www.nice.org.uk/guidance/ng217/chapter/Recommendations