Functional Movement Disorders

Many neurologic conditions involve abnormal movements (movement disorders), which can be quite similar to the abnormal and involuntary movements seen in Functional Movement Disorders. The diagnosis can be made during a clinic visit, often without further laboratory or imaging testing. While the exact cause of FMD is not fully understood, the clinical characteristics are well defined, and a clinician can make the diagnosis based on a person’s medical history and their neurologic exam. Importantly, there is treatment, which starts with understanding the diagnosis, and we believe our interdisciplinary approach will provide optimal care to the FMD community.  Together with my colleagues, we will formulate an individualized treatment plan, and initiate the therapies that can help you regain control of your body.

Psychological factors are not always the cause of FMD, but individuals with FMD often benefit from psychological treatment.

FMD can be a complicated and frustrating condition with which to live. Difficulties dealing with the health care system, stigma, loss of independence, and the burden associated with coping with a chronic condition are all factors that can lead to elevated stress levels and depression. Emotional distress, in turn, is known to exacerbate existing medical conditions and motor problems in particular. In addition, there is growing evidence from brain imaging studies that show for some individuals with FMD there is a disruption in brain networks involving emotion regulation and motor control. Studies suggest that for some people these disruptions are associated with stressful life events. While one size does not fit all, regulating mood is an important component for optimal management of FMD.

Health psychology is a branch of psychology that focuses on biological, social and psychological factors that influence health. Health psychologists focus on helping people engage in behaviors to improve health and improve coping with chronic medical conditions. They are ideally positioned to treat patients with FMD.

Our clinic provides evidenced-based interventions that have proven to be successful in the treatment of FMD, including Cognitive Behavioral Treatment (CBT), Dialectical Behavioral treatment (DBT), and Acceptance Commitment Therapy (ACT).

Some patients with FMD experience a cognitive decline in areas, such as attention, memory, processing speed and other thinking abilities.

Our neuropsychology group is available to assess and track these cognitive difficulties and recommend appropriate resources and strategies to help patients compensate for the areas in which they are struggling.

What to expect during a neuropsychological evaluation: A neuropsychological evaluation includes an interview, completion of self-report questionnaires, and paper and pencil or computerized tests. Assessments are completed either in the office or virtually. The entire evaluation usually takes approximately 4 hours. Breaks are provided as needed. You may take your medications as usual prior to and during our evaluations.

Physical Therapists (PT) can be a vital part of your healthcare team, especially in the process of healing from a FMD. They can help you understand the diagnosis of FMD, regain normal movement and sensation, guide you in forming more optimal brain connections, and work with you to pursue your functional goals, allowing you to thrive in your everyday life. Our PTs are devoted to following best evidence based practice with special emphasis on individualized needs and goals. Our mission is to restore hope, control, and confidence in self management of your condition.

Speech-Language Pathologists (SLP) specialize in treating swallowing, speech, voice, and cognitive-communication disorders. As FMD progresses, changes to both speech production and swallowing function may occur. SLPs are vital members of the team who evaluate and monitor these changes, along with helping to improve function in these areas that may be impacting quality of life.