Functional Neurological Disorder (FND) is a common neurological condition caused by a problem with the functioning of the nervous system. This is often described within the literature as a “software” issue of the nervous system rather than a “hardware” issue or organic central nervous system deficit (such as in brain or spinal injuries.)

FND describes a plethora of motor symptoms such as limb weakness, tremor, dystonia, sensory/gait or balance disturbance or sometimes non-motor symptoms such as blackouts, visual symptoms and bladder disturbance.

There is still so much to uncover within research about what goes wrong internally to cause FND, but we do know that people with FND do not have physical damage to their nervous system and so it’s not surprising that you can’t see /diagnose FND with diagnostic testing. Sometimes this leads people to think that clinicians are saying that their symptoms are not real! 

We know that instead, the nervous system is not functioning properly. Our role within neurological physiotherapy or often neuropsychology is to help the person understand their symptoms and how to rehabilitate. 

Firstly, a formal diagnosis of FND is important as you require a diagnosis to be under the management of the correct specialist team. The key first stage to commencing rehabilitation is that the person/family etc have received and accepted the diagnosis. Once diagnosis makes sense to you/family etc and you no longer feel concerned about ‘searching’ for an alternative diagnosis then this is prognostically a positive time to commence rehabilitation. 

Since about 2012 there has been increasing evidence to support the role of Physiotherapy as part of treatment for people with FND, especially those with functional movement disorders and limb weakness/ gait or balance disturbance. 

Neurological physiotherapists can be very helpful in improving the day-to-day limitations that people present with. They can also design a graded / functional exercise program that suits the individual’s symptoms which can help increase confidence in movement experience. 

Further information can be found at www.neurologicalsymptoms.org

Neuro Psychologists are key in the following areas:

• Assessment – Differentiating FND from other neurological disorders and identifying contributing factors.
• Psychoeducation – Helping patients understand FND and empowering them in recovery.
• Cognitive & Behavioural Therapy – Addressing emotional regulation, cognitive patterns, and dissociation.
• Cognitive Rehabilitation – Helping with attention, memory, and executive function difficulties.
• Multidisciplinary Support – Working with medical and therapy teams for comprehensive treatment programmes.

Here at Tees Neuro physiotherapy we have developed an innovative pathway for working with clients who have a formal diagnosis of FND. This combines a joint and specialist neurological physiotherapy and neuro psychology approach with clinicians who are experts in the management of FND here in the Northeast of England.

We have partnered with Dr Stephen Evans of Psychle Limited to provide a joint approach within the independent sector.

Dr Stephen Evans

Dr. Evans is a senior consultant in the NHS with substantial clinical experience in neuropsychology, having led the neuropsychology team in York and Scarborough since 2018. During this period, Dr. Evans established the functional neurological disorders (FND) clinical pathway across the region, developing an innovative service using existing resources to provide evidence-based care for patients with FND. Dr Evans now aims to replicate the success of the FND pathway in statutory services within the independent sector across Teesside. 

Our rehabilitation programmes are bespoke; we are individuals and therefore our rehabilitation should be goal driven, your programme will be designed to reflect this. Following assessment, our pathway offers up to 6 sessions of specialist neurological physiotherapy alongside up to 6 sessions of specialist neuropsychology.

Your rehabilitation experience may Include:

Neurological Physiotherapy 

• Land based movement re-education/facilitation (Hands on physiotherapy)
• Hydrotherapy
• Acupuncture
• Robotic Gait Training (Lexo)
• Functional Electrical Stimulation (FES)
• Videography/Imagery
• Movement repetition/home exercise programme
• Immersive Technology - (sensor based virtual reality such as Pablo/Tymo/Myro)
• Upper Limb Focussed Therapy

Neuropsychology 

• Psychoeducation
• Formulation and intervention using CBT and third wave cognitive therapies
• Cognitive rehabilitation
• Support with communicating FND with work or other external organisations
• Collaboration with OT and/or Neurophysiotherpy
• Signposting and recommendations for further therapy/treatment

Who Can Make a Referral?

We accept:

• Self-Referrals
• Case Management Referrals
• Solicitors on Behalf of their clients  
• Local NHS Commissioners

This is an exciting and innovative opportunity and if you require further information then please do not hesitate to contact a member of the team.

Phone: 01642 563222 

Email: victoria@teesneurophysiotherapy.com