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FND – Positive Diagnostic Communication — SCE Neurology MCQ

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HardNeuropsychiatryFND – Positive Diagnostic CommunicationSCE Neurology

A 40-year-old woman with functional neurological disorder presents with positive Hoover sign. Her neurologist uses this to explain the diagnosis to her. What is the correct approach to explaining FND to patients?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Explain the positive diagnosis using demonstrable signs and reversible nervous-system function

The best answer is “Explain the positive diagnosis using demonstrable signs and reversible nervous-system function”. FND is diagnosed positively from internally inconsistent or incongruent neurological signs and explained as a genuine disorder of nervous-system functioning, followed by individualised rehabilitation. The alternatives “Describe normal scans as proof that no neurological disorder exists”, “State that symptoms are consciously produced despite positive signs”, “Use psychiatric referral as the complete explanation and treatment”, “Avoid demonstrating Hoover sign during diagnostic communication, 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: NHS inform functional neurological disorder: https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/functional-neurological-disorder/