Functional Neurological Disorders – KnowNeuropsychology

These learning questions are brought to you by the KnowNeuropsychology / APPCN collaboration.

*This quiz has five multiple-choice questions and three discussion questions.

1 / 8

FND is a diagnosis of exclusion

True

False

2 / 8

Claire is a 34-year-old female being assessed due to concern for FND. She has a tremor in her right hand. With her permission, you attempt to identify a positive FND sign by holding the affected hand still so it cannot shake. In doing so, the other hand begins to shake. You then hold that hand still, and her foot begins to shake. This is a positive sign of FND called

Follow the Leader sign

Entrainment

Entrapment

Whack-a-mole sign

3 / 8

Gene’s mother, for whom he is the primary caregiver, sustained a stroke that resulted in hemiparesis and dysarthria. A year after her stroke, Gene presented to the emergency room with symptoms suggestive of a stroke. After careful examination and CT scan, it was determined that his symptoms were the result of a FND. This can be explained by what concept:

Mass hysteria

Mimicking

Illness exposure

Caregiver burden

4 / 8

The most consistent neuropsychological finding is that of:

Slowed processing speed

Impaired memory

Executive dysfunction

Visual impairments

5 / 8

Juan has a history of seizure onset in adolescence that was confirmed via video EEG. At 34 years of age, he is also experiencing seizures in which he is responsive to the environment and communicates while having full-body tonic-clonic movements. He breathes quickly and closes his eyes tightly during these episodes. When you evaluate him, you think:

The childhood epilepsy condition was misdiagnosed and is actually Psychogenic Nonepileptic Seizures (PNES).

It is possible to have both neurological and non-neurological conditions, so you are not surprised to see PNES co-occurring with a history of epilepsy.

His antiepileptic drugs should be increased to better control this new seizure presentation that has evolved over time.

He will likely fail performance validity testing and should be identified as malingering or having a Factitious Disorder.

6 / 8

Discussion Question: How else might a neuropsychological evaluation be used as a clinical or therapeutic tool for individuals with FND or a functional cognitive disorder (“Cogniform disorder”)?

7 / 8

Discussion Question: How might your assumptions and biases impact your ability to diagnose, assess, treat, and/or educate individuals with FND diagnoses?

8 / 8

Discussion Question: What kind of education and/or training have you received in FND? Would you feel comfortable evaluating or treating a patient with this condition? How might you seek out appropriate training, education and/or consultation?

Your score is

Non-Epileptic Seizures and Other Functional Neurological Disorders

Alison Buchholz, Ph.D.