Functional Neurological Disorder (FND)

A single resource containing current FND evidence based research

Last Updated 16th Oct 2020

Self-Management Resources

We have organised the self-management resources shared by HMR into a Google Drive folder. Please find the folder via the link below:

https://drive.google.com/drive/folders/1FLwB2gQR_isJ-mR8hc_c1kf0KFxwpUfA?usp=sharing

 

If teams have any other resources they would be happy to share, please send them.

 

Glossary of Terms

 

 

JARGON

ACTION TREMORtremor that appears during movement of the affected body part

ACTION POTENTIAL – rapid, transient, all-or-none nerve impulse initiated at the axon,

AGNOSIA – inability to recognize and interpret objects, people, sounds, or smells despite intact primary sense organs (e.g., inability to identify a sound despite intact hearing); typically results from damage to the occipital or parietal lobe

AKINESIA – inability to initiate movement due to difficulty selecting and/or activating motor programs in the central nervous system.

AFFERENT – sensory pathway proceeding toward the CNS from the peripheral receptor organs – / EFFERENT –  motor pathway proceeding from the CNS toward the peripheral end organs

ANTERIOR HORN (VENTRAL HORN) – Grey matter in the front of the spinal cord that contains motor neurons

APHASIA – syndrome of disordered expression or comprehension of spoken and/or written language caused by brain injury

APRAXIA – Impaired planning of sequencing of movement not caused by weakness, lack of co-ordination or sensory loss.

ASSOCIATED REACTIONS – movements of body parts other than the ones that are intended to move, often increased with increased effort

ATAXIA – incoordination of movement usually due to disease of cerebellar or sensory pathways

BASE OF SUPPORT – A reference point for movement within a posture and from one posture to another. Consists of the supporting surface, the body part in contact with it and the relationship of the whole body and the supporting surface.

BABINSKI – Extension of great toe which signifies a lesion of corticospinal tract. Upper motor neurone lesion.

BRADYKINESIA – slowed movement due to dysfunction of the basal ganglia and related structures

CENTRAL PATTERN GENERATOR – is a neural circuit that can produce a rhythmic motor pattern with no need for sensory feedback or descending control such as locomotion

CLASP KNIFE – spring-like resistance to passive extension at the elbow or flexion at the knee that increases up to a certain length and force before suddenly relaxing as the Golgi tendon organ is activated; sign of spasticity

CLONUS – rhythmic contraction relaxation tremor due to cyclic alternations of the spindle stretch reflex and the Golgi tendon organ reflex; indicative of exaggerated stretch reflexes

DYSKINESIA – blanket term for movement disorders characterized by increased motor activity

DYSARTHRIA – inability to pronounce or articulate words due to disorders of the vocal apparatus (e.g., lips, tongue, larynx)

DYSPHASIA – a language disorder in which there is an impairment (but not loss) of speech and of comprehension of speech

DYSPHAGIA – the symptom of difficulty in swallowing

DYSTONIA – involuntary muscle spasms that produce peculiar postures of different body parts

EXTRAPYRAMIDAL movement disorder not involving the corticospinal tracts; typically refers to basal ganglia or cerebellar disorders

EQUILIBRIUM REACTIONS – Automatic adaptations of postural tone in response to gravity and displacement. Functionally they maintain a postural alignment. They can not be performed voluntary.

FACILITATION – Neural facilitation in neuroscience, is the increase in postsynaptic potential evoked by a 2nd impulse

FLACIDITY – Lacking firmness, resilience or muscle tone

FUNCTIONAL – not due to organic disease

HEMIANOPIA – loss of vision in one half of the visual field, indicating a pathological process posterior to the optic chiasm

KEY POINTS OF CONTROL – A body part through which we can use prorioceptive control to tap into the motor systems to change motor output.

CENTRAL KEY POINT – Position of maximal rotation in thorax T8. CKPs can be different between patients. Not an anatomic structure. Movement can be facilitated from CKP.

DISTAL KEY POINTS – hands & feet

POSTERIOR HORN (DORSAL HORN) grey matter in the back of the spinal cord that receives sensory information from the body through the dorsal root ganglia

PROXIMAL – Shoulders & hips

MYOCLONUS – sudden, shock-like, jerking contraction of a group of muscles

MYOPATHY – muscle disease; manifested by lower motor neurons weakness that is usually proximal > distal

NEGLECT – failure to acknowledge stimuli toward the side of space opposite to a hemispheric (usually parietal) lesion

NYSTAGMUS – involuntary, rhythmic oscillation or trembling of the eyeballs

PARAPLEGIA paralysis of both legs

POSTURAL CONTROL/POSTURAL STABILITY – Ability to control body position in space for the dual purpose of stability and orientation

POSTURAL ORIENTATION – Maintains alignment between body and segments, between body and environment and involves establishing a vertical orientation.

POSTURAL INSTABILITY – loss of ability to make postural adjustments in response to perturbations, i.e., defect in righting reflex; common in Parkinson disease

POSTURAL SET – Alignment of key points to each other in relation to an accepted base of support. It provides an assessment of postural orientation.

PROPRIOCEPTION – Awareness of spatial and mechanical status of the musculoskeletal framework

QUADRAPLEGIA (tetraplegia) paralysis of all four extremities

RECIPROCAL INNERVATION – Modulation of excitation and inhibition within CNS. The interplay of muscle activity in patterns of selective postural movement.

RIGHTING REACTIONS – Sequencing of selective movement in patterns in response to displacement.

Functionally they allow the loss and regaining of midline through – trunk righting, head righting, stepping reactions, protective extension of the upper limb.

Components can be performed voluntary.

RIGIDITY – increased resistance throughout the range of motion when passively moving a body part due to co-contraction of agonist and antagonist muscles (“lead pipe”)

SELECTIVE MOVEMENT – Controlled movement

SPASTICITY – abnormal increase in muscle tone and reflexes, manifested as a velocity dependent spring-like resistance to moving or being moved; indicates an upper motor neuron lesion

STEREOGNOSIS – ability to recognize objects by touch

 

 

Vocational Rehabilitation Training

Please find below the Vocational Rehabilitation Cascade Package content following the 2 day training event.

You will find attached:

  • 1 hour Cascade Training Package (3 x documents – 1 x PowerPoint slides, 1 x Handouts for Trainee’s, 1 x Notes Pages for Trainers)
  • 3 hour Cascade Training Package (3 x documents – 1 x PowerPoint slides, 1 x Handouts for Trainee’s, 1 x Notes Pages for Trainers)
  • Cascade Package Instructions
  • AHP Advisory Fitness for Work Report (2 documents – 1 x blank and 1 x example of completed document)
  • Signposting Document
  • Reference List
  • Cascade Training Evaluation Form
  • Contact Details for GM Disability Employment Advisors