{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:22:36Z","timestamp":1791357756651,"version":"4.3.1"},"reference-count":25,"publisher":"BMJ","issue":"4","funder":[{"name":"Massachusetts General Hospital Physician-Scientist Development Award"},{"DOI":"10.13039\/100001479","name":"Sidney R. Baer, Jr. Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001479","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2018,4,24]]},"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:p>Patients with functional neurological disorders (FND)\/conversion\u2009disorder commonly present to outpatient clinics. FND is now a \u2018rule in\u2019 diagnosis based on neurological examination findings and semiological features. While neurologists may be more comfortable diagnosing patients with FND, there is only limited guidance as to how to conduct follow-up outpatient visits. Using clinical vignettes, we provide practical suggestions that may help guide clinical encounters including how to: (1) explore illness beliefs openly; (2) enquire longitudinally about predisposing vulnerabilities, acute precipitants and perpetuating factors that may be further elucidated over time; (3) facilitate psychotherapy engagement by actively listening for potentially unhelpful or maladaptive patterns of thoughts, behaviours, fears or psychosocial stressors that can be reflected back to the patient and (4) enquire about the fidelity of individual treatments and educate other providers who may be less familiar with FND. These suggestions, while important to individualise, provide a blueprint for follow-up FND clinical care.<\/jats:p>","DOI":"10.1136\/practneurol-2017-001835","type":"journal-article","created":{"date-parts":[[2018,5,15]],"date-time":"2018-05-15T16:20:23Z","timestamp":1526401223000},"page":"323-330","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":57,"title":["You\u2019ve made the diagnosis of functional neurological disorder: now what?"],"prefix":"10.1136","volume":"18","author":[{"given":"Caitlin","family":"Adams","sequence":"first","affiliation":[{"name":"Functional Neurology Research Group, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"},{"name":"Department of Psychiatry, Alpert Medical School, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth N","family":"Madva","sequence":"additional","affiliation":[{"name":"Functional Neurology Research Group, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Curt","family":"LaFrance Jr","sequence":"additional","affiliation":[{"name":"Department of Neurology, Alpert Medical School, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"},{"name":"Department of Psychiatry, Alpert Medical School, Rhode Island Hospital, Brown University, Providence, Rhode Island, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2721-583X","authenticated-orcid":false,"given":"David L","family":"Perez","sequence":"additional","affiliation":[{"name":"Functional Neurology Research Group, Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA"},{"name":"Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,5,15]]},"reference":[{"key":"2025090410363224000_18.4.323.1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp220"},{"key":"2025090410363224000_18.4.323.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2010.05.011"},{"key":"2025090410363224000_18.4.323.3","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2012-000422"},{"key":"2025090410363224000_18.4.323.4","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.177204"},{"key":"2025090410363224000_18.4.323.5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2012-304607"},{"key":"2025090410363224000_18.4.323.6","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1017\/S109285291600002X","article-title":"Nonepileptic seizures: an updated review","volume":"21","author":"Perez","year":"2016","journal-title":"CNS Spectr"},{"key":"2025090410363224000_18.4.323.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2009.02099.x"},{"key":"2025090410363224000_18.4.323.8","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2014-309255"},{"key":"2025090410363224000_18.4.323.9","doi-asserted-by":"crossref","unstructured":"Gardiner P , MacGregor L , Carson A , et al . Occupational therapy for functional neurological disorders: a scoping review and agenda for research. CNS Spectr 2017:1\u20138. doi:10.1017\/S1092852917000797","DOI":"10.1017\/S1092852917000797"},{"key":"2025090410363224000_18.4.323.10","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318228c0c7"},{"key":"2025090410363224000_18.4.323.11","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181e39658"},{"key":"2025090410363224000_18.4.323.12","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1001\/jamapsychiatry.2014.817","article-title":"Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial","volume":"71","author":"LaFrance","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"2025090410363224000_18.4.323.13","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2010.233114"},{"key":"2025090410363224000_18.4.323.14","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awp060"},{"key":"2025090410363224000_18.4.323.15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.yebeh.2014.07.001","article-title":"Providers' perspectives on treating psychogenic nonepileptic seizures: frustration and hope","volume":"37","author":"McMillan","year":"2014","journal-title":"Epilepsy Behav"},{"key":"2025090410363224000_18.4.323.16","doi-asserted-by":"publisher","DOI":"10.1136\/practneurol-2015-001242"},{"key":"2025090410363224000_18.4.323.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(98)00114-7"},{"key":"2025090410363224000_18.4.323.18","first-page":"367","article-title":"Causal illness attributions in somatoform disorders: associations with comorbidity and illness behavior","volume":"57","author":"Rief","year":"2004","journal-title":"J Psychosom Res"},{"key":"2025090410363224000_18.4.323.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2004.03.013"},{"key":"2025090410363224000_18.4.323.20","unstructured":"Williams C , Kent C , Smith S , et al . Overcoming functional neurological symptoms: a five area approach. Florida, USA: CRC Press, 2011."},{"key":"2025090410363224000_18.4.323.21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S1525-5069(02)00505-4","article-title":"Treatment of nonepileptic seizures","volume":"3","author":"LaFrance","year":"2002","journal-title":"Epilepsy Behav"},{"key":"2025090410363224000_18.4.323.22","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2009.06.004"},{"key":"2025090410363224000_18.4.323.23","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.48.3.230"},{"key":"2025090410363224000_18.4.323.24","doi-asserted-by":"crossref","unstructured":"LaFrance Jr WC , Wincze J . Treating nonepieptic seizures: therapist guide. New York: Oxford Univeristy Press, 2015.","DOI":"10.1093\/med:psych\/9780199307173.001.0001"},{"key":"2025090410363224000_18.4.323.25","doi-asserted-by":"crossref","unstructured":"Reiter J , Andrews D , Reiter C , et al . Taking control of your seizures: workbook. New York: Oxford University Press, 2015.","DOI":"10.1093\/med:psych\/9780199335015.001.0001"}],"container-title":["Practical Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/practneurol-2017-001835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T17:36:39Z","timestamp":1757007399000},"score":1,"resource":{"primary":{"URL":"https:\/\/pn.bmj.com\/lookup\/doi\/10.1136\/practneurol-2017-001835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,15]]},"references-count":25,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,7,12]]},"published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1136\/practneurol-2017-001835"],"URL":"https:\/\/doi.org\/10.1136\/practneurol-2017-001835","relation":{},"ISSN":["1474-7758","1474-7766"],"issn-type":[{"value":"1474-7758","type":"print"},{"value":"1474-7766","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,15]]}}}