What are the recommended referral pathways for patients with FND who require specialist input?

For patients with suspected FND who require specialist input, refer to a neurology specialist for further assessment and confirmation of the diagnosis, ideally to a general neurology clinic, acute neurology service, or symptom-specific service such as first fit, movement disorders, or cognitive clinic, depending on clinical judgement ¹.

If there is a confirmed positive diagnosis of FND following specialist neurology assessment, it is important to explain that FND is a rule-in diagnosis based on positive physical signs, and symptoms are genuine and potentially reversible ¹.

Referral to psychological support, including cognitive behavioural therapy (CBT), may be appropriate for some individuals, especially those with functional seizures, to help identify triggers and provide management strategies ¹.

In cases of uncertainty, severe, or complex symptoms, or if there is a relapse despite management, referral to a neurology or other relevant specialist should be arranged ¹.