What are the recommended management strategies for patients with Functional Neurological Disorder in a primary care setting?

In a primary care setting, the recommended management strategies for patients with Functional Neurological Disorder (FND) include:

• Recognition and reassurance: Be aware that memory problems and concentration difficulties may be part of FND and do not necessarily require re-referral if there are no new neurological signs.
• Assessment of new symptoms: New neurological symptoms or signs in patients with a specialist diagnosis of FND should be assessed according to relevant neurological guidelines to exclude other causes.
• Avoid unnecessary referrals: Do not routinely refer adults with concentration difficulties related to FND for neurological assessment unless new signs emerge.
• Patient involvement: Engage patients in discussions about their condition and management, ensuring they are informed and involved in decision-making.
• Support and education: Provide information and support to help patients understand their condition and manage symptoms, potentially including referral to specialist multidisciplinary teams if available.

Overall, management in primary care focuses on careful clinical assessment, reassurance, symptom management, and appropriate referral only when new or progressive neurological signs develop.

References: NICE NG127