WORKSHOP: Functional Neurological Disorders Evolving Research and A Practical Guide for Psychiatrists

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Presenting Author(s): Dr. Gabriela Gilmour, MD, Dr. Megan Howlett, Dr. Kimberly Williams, BSc (Pharmacology), MSc (Global Health)

Date and time: 20 Mar 2026 from 15:15 to 16:00

Location: Mount Temple Ballroom A/B  

Learning Objectives

1. To explore evolving neuroscientific understanding of functional neurological disorders and how they are a disorder of the mind and the brain;
2. To become familiar with different subtypes of functional neurological disorder;
3. To recognize risk factors for functional neurological disorder and common symptoms/signs; and
4. To examine how to manage different types of functional disorders as a psychiatrist including functional dissociative seizures, functional cognitive disorder, and functional movement disorder.

Abstract

Background: Functional Neurological Disorder (FND) is a common and disabling condition that exists at the interface of the brain, mind and body. Patients experience various symptoms, including hyperkinetic and hypokinetic movements, cognitive difficulties, spells, and others. Approaching patients experiencing FND with a biopsychosocial framework allows for the recognition of multiple risk factors, triggers of symptoms, and perpetuating factors. 1, 2 Over the past 20 years there has been a significant expansion in our understanding of FND and the neuroscience underlying its mechanism3. As part of this, there is an emergence of data on phenotypes of functional neurological disorder that are relevant to treating neurologists and psychiatrists4. Improved understanding of this condition has allowed for the development of novel therapeutic approaches, including specialist physiotherapy, occupational therapy, speech-language pathology, multi-/interdisciplinary rehabilitation and psychotherapy, or combinations of these5-11. Despite this, FND remains undertreated and underfunded, with significant associated healthcare costs12, 13. 

Purpose: Patients with FND frequently attend psychiatric clinics14. They are patients who have often experienced stigma and benefit from adequate support, with the potential for recovery. Giving psychiatrists an understanding of the evolution of the field over the past 15 years, an understanding of subtypes15, and therapeutic modalities will help them to be more prepared to support these patients16. 

Format: This 45 minute workshop will include a didactic review of emerging literature of FND, interactive case formulation examples, and opportunity for brainstorming evidence-based treatment strategies for the general psychiatrist. Fifteen minutes will be allocated for questions and answer. 

Literature References

1. Drane DL, Fani N, Hallett M, Khalsa SS, Perez DL, Roberts NA. A framework for understanding the pathophysiology of functional neurological disorder. CNS Spectr 2021; 26(6): 555-561 
2. Perez DL, Aybek S, Popkirov S, et al. A review and expert opinion on the neuropsychiatric assessment of motor functional neurological disorders. J Neuropsychiatry Clin Neurosci 2021; 33(1): 14-26. 
3. Jungilligens J, Paredes-Echeverri S, Popkirov S, Barrett LF, Perez DL. A new science of emotion: implications for functional neurological disorder. Brain. 2022 Aug 27;145(8):2648-2663. doi: 10.1093/brain/awac204. PMID: 35653495; PMCID: PMC9905015. 
4. Gilmour GS, Langer LK, Lang AE, MacGillivray L, Lidstone SC. Neuropsychiatric phenotypes in functional movement disorder. CNS Spectrums. 2023;28(6):747-755. doi:10.1017/S1092852923002353 
5. Gilmour GS, Nielsen G, Teodoro T, et al. Management of functional neurological disorder. J Neurol 2020; 267(7): 2164-2172. https://doi.org/10.1007/s00415-020-09772-w. 
6. Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation. J Neurol Neurosurg Psychiatry 2015; 86(10): 1113-1119. 
7. Baker J, Barnett C, Cavalli L, et al. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. J Neurol Neurosurg Psychiatry 2021; 92(10): 1112-1125. 
8. Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. J Neurol Neurosurg Psychiatry 2020; 91(10): 1037-1045. 
9. Nielsen G, Stone J, Lee TC, et al. Specialist physiotherapy for functional motor disorder in England and Scotland (Physio4FMD): a pragmatic, multicentre, phase 3 randomised controlled trial. Lancet Neurol 2024; 23(7):675-686 
10. Crespo-facorro B, Ruiz-veguilla M, Mir P. Combined physiotherapy and cognitive behavioral therapy for functional movement disorders a randomized clinical trial. JAMA Neurol2024; 81(9): 966-976. 
11. Bhatt H, MacGillivray L, Gilmour GS, Marcelle K, Langer L, Lidstone SC. Integrated model of care for functional movement disorder: targeting brain, mind and body. Disabil Rehabil 2024; 47(6): 1433-1441. https://doi.org/10.1080/09638288.2024.23 
12. Stephen CD, Fung V, Lungu CI, Espay AJ. Assessment of emergency department and inpatient use and costs in adult and pediatric functional neurological disorders. JAMA Neurol 2021; 78(1): 88-101. 
13. Stephen CD, Fung V, Perez DL, Espay AJ. Comparison of inpatient and emergency department costs to research funding for functional neurologic disorder: an economic analysis. Neurology 2025; 104(6):e213445. 
14. Stone J, Carson A, Duncan R, Roberts R, Warlow C, Hibberd C, Coleman R, Cull R, Murray G, Pelosi A, Cavanagh J, Matthews K, Goldbeck R, Smyth R, Walker J, Sharpe M. Who is referred to neurology clinics?-- the diagnoses made in 3781 new patients. Clin Neurol Neurosurg. 2010 Nov;112(9):747-51. doi: 10.1016/j.clineuro.2010.05.011. Epub 2010 Jun 19. PMID: 20646830 
15. Hallett, M, Aybek, S., Dworetzky, B., McWhirter, L., Staff, J., & Stone, J. (2022). Functional neurological disorder: new subtypes and shared mechanism. Lancet Neurology, 21, 537-550. 
16. Gilmour, G.S., Fritz, K., Stephen, J., Kain, K., Brunet, M., Fitzsimmons, M., Krueger, N., Lawlor-Savage, L., McEachern, K., Mitchell, L., Squires, H., Vaillant, P., Walker, K., Howlett, M. and Williams, K.G. (2025), Developing an Outpatient Transdisciplinary Functional Movement Disorder Program: 1-Year Experience. Mov Disord Clin Pract. https://doi.org/10.1002/mdc3.70183