Podcasts about fnd

In part five of this seven-part series on FND, Dr. Jon Stone and Dr. Gabriela Gilmour discuss treatment options.  Show citation:  Gilmour, G.S., Nielsen, G., Teodoro, T. et al. Management of functional neurological disorder. J Neurol 267, 2164–2172 (2020). https://doi.org/10.1007/s00415-020-09772-w  Gilmour GS, Langer LK, Bhatt H, MacGillivray L, Lidstone SC. Factors Influencing Triage to Rehabilitation in Functional Movement Disorder. Mov Disord Clin Pract. 2024;11(5):515-525. doi:10.1002/mdc3.14007  Stone J, Carson A. Multidisciplinary Treatment for Functional Movement Disorder. Continuum (Minneap Minn). 2025;31(4):1182-1196. doi:10.1212/cont.0000000000001606 Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. doi:10.1212/WNL.0000000000214466  Show transcript:  Dr. Jon Stone: Hello, this is Jon Stone with the Neurology Minute. Gabriela Gilmour and I are back to continue with part five of our seven-part series on FND. Today we'll be discussing treatment. Gabriela, talk us through what the rehabilitation or therapy approaches exist for FND now. Dr. Gabriela Gilmour: I would start actually even before jumping into rehabilitation and therapy to again emphasize something that we talked about in the last episode, which is that rehabilitation very much starts at our first visits with our patients when we examine for positive signs and show these to our patients and explain what they mean. So education about FND is really a fundamental treatment step, and I think we as neurologists have so much to offer to our patients in these visits. Next, when we're thinking about rehabilitation for FND, this often includes some combination of physical rehabilitation and psychological therapy and really should be individualized to each patient. So multidisciplinary or integrated therapy approaches are the gold standard and treatment strategies with these are really guided by our evolving understanding of the mechanisms of FND. So for example, this means using strategies like distraction, motor visualization, relaxation and mindfulness to target that underlying mechanism of FND. And then we use psychological therapies to also address perpetuating factors. So as we have discussed in this series, patients often experience many symptoms. So we also want to think about those other symptoms in our treatment plan, whether that be chronic pain or sleep disturbance or treating comorbid psychiatric or neurological illness. When we think about the subtypes of FND, there is some research into specific strategies for each. So psychotherapy, in particular, cognitive behavioral therapy is the focus for functional dissociative seizures with strategies aimed at attack prevention. Whereas for functional movement disorder, motor retraining physiotherapy has the most evidence. One big thing that I want to emphasize though is that rehabilitation for FND really relies on patient self-management and patient engagement. So I often explain to my patients that I can't retrain their brain, but I can help support them in this process and doing this for themselves. Dr. Jon Stone: So when you meet a patient with FND, how do you decide whether therapy is going to be helpful for them? I think people often have a tendency to say, "Oh, it's FND right off you go to psychotherapy or physiotherapy," but is that always the right option? How should we try and help our patients to decide if it's the right time for them to do these treatments? Dr. Gabriela Gilmour: Yeah, I think that that's something that's really maybe not unique, but something that's really important to FND and to treatment planning and FND. When we're supporting our patients as they embark on a treatment pathway, we really want to set them up for success. And so this really does rely on a robust triage process. So unlike other neurological conditions where you have X disease, therefore, why is the treatment? For FND, we've got a host of different types of treatments, and we want to individualize that and we want to time it right. Fundamentally, we really want to select the right treatment for our patients, and that relies on us understanding what symptoms are most bothersome to our patients, and we want to then provide that treatment at the right time. And I think right time is really what I would emphasize as being so, so important. So this means that patients are ready for active participation and rehabilitation, they're enthusiastically opted in. They think that treatment's going to help, and there aren't major barriers that are going to impact their ability to participate fully, so things like severe pain that could get in the way. And this is a conversation that I have really openly with my patients, and I really try to let them guide the timing. They will let me know, "Hey, I'm a teacher, and I'm in school right now. Now is not the right time for me to embark on this, but what about in June or July?" And then we revisit and regroup at that time. So really I do let my patients guide this process, but I would say that there are a subset of patients that don't need these more advanced rehabilitation type programs. Maybe are spontaneously improved or are able to implement some of their own self-management strategies on their own and have a significant improvement in symptoms already. Dr. Jon Stone: We need to make it easy for our patients to tell us when it's not the right time, but also, there's no one-size-fits-all, basically. Dr. Gabriela Gilmour: Absolutely. Dr. Jon Stone: So we'll be back for more Neurology Minute to continue our discussion on FND. We'll be talking about prognosis. Thanks for listening.

In part four of this seven-part series on FND, Dr. Jon Stone and Dr. Gabriela Gilmour discuss the diagnostic explanation.  Show citation:  Stone J. Functional neurological disorders: the neurological assessment as treatment. Pract Neurol. 2016;16(1):7-17. doi:10.1136/practneurol-2015-001241  Gilmour GS, Lidstone SC. Moving Beyond Movement: Diagnosing Functional Movement Disorder. Semin Neurol. 2023;43(1):106-122. doi:10.1055/s-0043-1763505  Podcast transcript:  Dr. Gabriela Gilmour: This is Gabriela Gilmour with the Neurology Minute. Jon Stone and I are back to continue with part four, of seven, of our series on functional neurological disorder. Today we will focus on the diagnostic explanation. So many patients have never heard of FND before receiving this diagnosis. Can you share how you explain the diagnosis to your patients? Dr. Jon Stone: So I'm aware that many neurologists do find this difficult. And I have to say, having thought about it for 20 years or so now, I think the answer is, don't be weird. Do what you normally do with any condition, when you explain it to patients. I think what goes wrong is that people see FND as something weird and other, and they start to do weird things like telling people that their scans are normal, or telling them what they don't have before they've started to tell them what they do. If you go with the normal rules of explanation, first of all, starting by giving it a name that you prefer, so you've got FND, or try and be specific if you can. You've got functional seizures, functional movement disorder. Give it a name to start with. Don't sort of spend a long time beating around the bush before you do that. Talk a bit about why you've made the diagnosis, because that's what you normally do. So if someone's got a weak leg, show them their Hoover's sign. I think actually showing people their physical signs is probably one of the most powerful things you can do, brings the diagnosis away from the scanner and into the clinic room. And also, they can see in front of them the potential for improvement. So it feeds forward into treatment. Yes, you might need to explain why they don't have some other conditions that they're worried about, but you can leave discussions about why it's happened for later. I think what tends to go wrong is people jump into that too early. So the bottom line, just do what you normally do and things generally go a lot more smoothly. Dr. Gabriela Gilmour: And when you're providing the diagnostic explanation, it can be really helpful to link the patient's experience and their symptoms to the diagnosis. And so, I wonder how you integrate that piece into your diagnostic explanation, or how you tailor your explanation to an individual patient. Dr. Jon Stone: Yeah, I think tailoring is really important here. And this is where obviously if you've done your assessment, so helpful to ask the patient is, "Well, what do you think's wrong? What things were you worried about? " Some people say, "Look, I'm really worried I've got MS." Or some people say, "I haven't got FND. I've read about that. " Or sometimes people are wondering if they've got FND. So, you've got to try and tailor it to what the person is expecting and particularly previous experiences. If they're telling you how angry they were about doctors A, B, and C, then obviously you want to use that and try not to end up with the same outcome. Why would there be a problem with this diagnosis? It's because they haven't heard about it, because they've got misconceptions about it. Do they feel that this diagnosis would be saying it's all in their mind or something like that? You might need to be explicit about that. But I think this links into how, it's not just about the diagnostic label, it's about a formulation, which is something we don't think about much in neurology. So there's a label for what's wrong, but in FND, a formulation, why have you got FND, in your particular case, is what we're sort of moving on to there based on the story that you've heard. Dr. Gabriela Gilmour: Yeah. And I think in my experience and in working with trainees, really just practicing, saying it, is so important and saying it in a way that feels honest and correct to you as a clinician. Dr. Jon Stone: Yeah, absolutely. Dr. Gabriela Gilmour: So we will be back for more Neurology Minute episodes to continue our discussion on FND. Next, we're going to be talking about treatment. Thanks for listening.

In part three of this seven-part series on FND, Dr. Jon Stone and Dr. Gabriela Gilmour discuss causes of functional neurologic disorder.  Show citation:  Hallett M, Aybek S, Dworetzky BA, McWhirter L, Staab JP, Stone J. Functional neurological disorder: new subtypes and shared mechanisms. Lancet Neurol. 2022;21(6):537-550. doi:10.1016/S1474-4422(21)00422-1 Show transcript:  Dr. Gabriela Gilmour: This is Gabriela Gilmour with the Neurology Minute. Jon Stone and I are back to continue with part three of our seven-part series on functional neurological disorder. Today, we will focus on the causes of FND. So Jon, there have been many advances in our understanding of the mechanism of FND in the last 10, 15 years. And so what do we know about this now? Dr. Jon Stone: I think the key message I want to get across here is that whereas previously we had a very psychiatric, purely psychiatric view of FND, it used to be called conversion disorder, what we've got now is a multi-perspective view of the mechanisms, which mean that we can understand FND at a kind of neural level or brain circuit level, but we can also still retain the importance of psychological factors, traumatic events. And I think it's also important to separate out, as you've done here with a question, what's the mechanism? How is the symptom happening versus why is it happening? Which often people don't do. So for this question, how is it happening? How is it that somebody, for example, gets a weak leg? Well, at a very simple level, their brain is disconnecting from their leg and that's what dissociation is. And you can explain that to patients at sort of brain circuit level. We've learned that there are disruptions probably in the circuits in our brain that relate to that sense of agency, the parts of our brain that tell us that our bodies belong to us. And people are particularly interested in an area called the temporary parietal junction. And at a higher broader level, people are particularly interested in the idea that FND is a disorder that you would expect to happen based on our understanding of the brain as a predictive organ. So if the brain spends its time predicting things, maybe in FND what's gone wrong is this is very strong prediction that the leg is weak or that there's a tremor or that a seizure's about to happen that overrides sensory input telling our brain otherwise. Dr. Gabriela Gilmour: And I guess to follow into that, you mentioned what is going on. So now can you talk a little bit about why somebody might develop FND or the etiology of FND? Dr. Jon Stone:  I think this helps clinically as well as neurologists, because we can talk about mechanism as we would, for example, with MS as inflammation, but why is there inflammation? So okay, the brain's gone wrong, but why has it gone wrong? And there we need a much more complex view of multiple range of risk factors, predisposing, precipitating, and perpetuating that we know are associated with FND, but vary a lot from person to person. So no one person's the same. If you've had traumatic experiences in the past, that will make you more prone to dissociation. If you've had other functional disorders, if you have almost certainly some forms of genetics make people predisposed. And then as we said in the last episode, having another neurological condition, so having migraine aura, a physical injury, an infective illness, these are powerful reasons to trigger neurological symptoms. And it's not so much why they happen. It's more why do they get there and get stuck? We all probably have transient functional symptoms actually, but why they get stuck in people with FND for various reasons to do with the way their brains work or their past experiences, or sometimes what happens to them in medical systems. So developing a very open idea about why someone might have FND really helps you, I think, explain that back to patients and produce individual sort of formulations of the problem. Dr. Gabriela Gilmour: Yeah. And I often say to my patients, "I don't know exactly why you, why today have this." And that's true in medicine in general. We actually often don't know why anybody develops any medical condition with a few exceptions, but we know about risk factors really. Dr. Jon Stone: Absolutely. It's one of the reasons I hate the term medically unexplained. Actually, I think FND is perhaps more explained in some ways than some of the other conditions like multiple sclerosis and ALS that we actually deal with where we really don't know why they happen. Dr. Gabriela Gilmour: Well, we will be back for more Neurology Minute episodes to continue our discussion on FND. Thanks for listening. 

Another set of intriguing cases from the latest issue of the journal, pored over by the Case Reports team.  In the first case, a 24-yo man presents acutely with reduced consciousness, following 3 days of right-sided headache. His mother reports sudden behavioural changes with jerky movements and enlarged pupils. He is agitated, not obeying commands and not moving his left-side limbs. He had a history of autism and vascular Ehlers-Danlos syndrome and was on medication for stroke prevention. An MRI scan led to a differential diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES), but the final conclusion came post-discharge after a further review of his scans.  https://pn.bmj.com/content/25/6/549 The second report (19:37) describes two curious instances of functional neurological disorder (FND), both of which improved after the patients were in comatose states. The first patient is a 59-yo man who had developed muscle weakness shortly after at car crash at age 49, and had subsequently been reliant on a wheelchair for more than 8 years. Recently the patient had been infected simultaneously with severe cases of flu and COVID-19, during which he had been sedated and placed in an induced coma for several weeks. Awakening from the coma, the patient showed surprising signs of new mobility. In the second patient, a 40-yo woman presented with flaccid paralysis of her left arm, with loss of sensation up to the shoulder. She had a history of bipolar disorder and agoraphobia. She was diagnosed with FND and participated in physiotherapy and hypnotherapy with no improvement. Thirteen months later she was readmitted following an overdose on a mix of analgesics and sedatives, and was ventilated in the ITU for several hours. Upon waking the patient noticed that her previously paralyzed arm had completely recovered. https://pn.bmj.com/content/25/6/562  Further reading: Advances in functional Neurological disorder (BMJ Neurology Open)   The case reports discussion is hosted by Prof. Martin Turner¹, who is joined by Dr. Ruth Wood² and Dr. Babak Soleimani³ for a group examination of the features of each presentation, followed by a step-by-step walkthrough of how the diagnosis was made. These case reports and many others can be found in the October 2025 issue of the journal. (1) Professor of Clinical Neurology and Neuroscience at the Nuffield Department of Clinical Neurosciences, University of Oxford, and Consultant Neurologist at John Radcliffe Hospital. (2) Neurology Registrar, University Hospitals Sussex. (3) Clinical Research Fellow, Oxford Laboratory for Neuroimmunology and Immunopsychiatry, Nuffield Department of Medicine, University of Oxford Please subscribe to the Practical Neurology podcast on your favourite platform to get the latest podcast every month. If you enjoy our podcast, you can leave us a review or a comment on Apple Podcasts (https://apple.co/3vVPClm) or Spotify (https://spoti.fi/4baxjsQ). We'd love to hear your feedback on social media - @PracticalNeurol. Production and editing by Brian O'Toole. Thank you for listening.

In part two of this series, Dr. Jeff Ratliff and Dr. Dara Albert discuss what advice they have for people who care for patients with FND.  Show citation:  Miller R, Lidstone S, Perez DL, Albert DVF. Education Research: Targeting Self-Described Knowledge Gaps to Improve Functional Neurologic Disorder Education Among Clinicians. Neurol Educ. 2025;4(3):e200239. Published 2025 Sep 5. doi:10.1212/NE9.0000000000200239 

In this episode of The Neuro Reset Podcast, Dr. Teames welcomes back Jami, who shares her ongoing journey with functional neurological disorder (FND) after intensive treatment in January 2025. Jami discusses her struggles with identifying triggers, setbacks after leaving the clinic, and the importance of mindset, self-care, and consistent mind-body practices in long-term recovery. The conversation highlights the challenges of pacing, the necessity of self-compassion, and the power of gratitude and self-awareness in managing FND, offering hope and practical strategies for others facing similar neurological conditions. Request a consult: 480-674-9199 https://desertbrainandspine.com

Send us a textVoid Signal welcomes Jake Desrochers of darkwave industrial project HOLY WATER to discuss his powerful new album Contrast. Known for raw, high-energy performances that emphasize authenticity and emotional connection, Jake shares insights into his creative process, the meaning behind standout tracks like “Tasted Tears, Wasted Time,” and the role of community, resilience, and second chances in both his music and life. This episode is a heartfelt exploration of art, vulnerability, and the bonds that make music transformative.Featured Songs:HOLY WATER - EYE.LL.FND. Uhttps://holywater-music.bandcamp.com/ for more HOLY WATER.Void Signal intro courtesy of Processor. Visit https://processor2.bandcamp.com for more Processor.Void Signal intro remix by Mortal Realm. Visit https://mortalrealm.bandcamp.com/ for more Mortal Realm.Support the showVoid Signal is ad-free and powered by people. Visit https://VoidSignal.net to support Void Signal and enjoy exclusive episodes, series, and more.

In part two of this seven-part series on FND, Dr. Jon Stone and Dr. Gabriela Gilmour discuss pitfalls in the diagnostic process.  Show citation:  Finkelstein SA, Popkirov S. Functional Neurological Disorder: Diagnostic Pitfalls and Differential Diagnostic Considerations. Neurol Clin. 2023;41(4):665-679. doi:10.1016/j.ncl.2023.04.001   

In part one of this seven-part series on FND, Dr. Jon Stone and Dr. Gabriela Gilmour discuss the process of diagnosing FND.  Show citation:  Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;376:o64. Published 2022 Jan 24. doi:10.1136/bmj.o64 

Dr Sumeet Singhal, consultant neurologist at Nottingham University Hospitals NHS Foundation Trust, discussed about Clinical approach to FND . 

In part one of this series, Dr. Jeff Ratliff and Dr. Dara Albert discuss the themes or buckets that self-identified FND knowledge gaps fall into.  Show citation:  Miller R, Lidstone S, Perez DL, Albert DVF. Education Research: Targeting Self-Described Knowledge Gaps to Improve Functional Neurologic Disorder Education Among Clinicians. Neurol Educ. 2025;4(3):e200239. Published 2025 Sep 5. doi:10.1212/NE9.0000000000200239 

Jason Kreuzman is a pediatric occupational therapist based in St. Louis, Missouri, specializing in Functional Neurological Disorder (FND) and chronic pain. He is the Co-Chair of the FND Society Pediatric Committee and the Chair of the Multidisciplinary FND Committee at St. Louis Children's Hospital. As the founder of Rewire OT, Jason is opening a new outpatient clinic and leading the charge to create pediatric OT/PT treatment guidelines for FND. He joins us to demystify this complex condition and share a hopeful, practical path to recovery.Description:What is Functional Neurological Disorder (FND), and how is it similar to concussion recovery? In this fascinating episode, pediatric occupational therapist Jason Kreuzman breaks down FND—a disorder where the brain and body's communication goes awry, causing very real, debilitating symptoms like functional seizures, limb weakness, and tremors.Jason shares his journey into this niche field, the heartbreaking stigma patients face, and the striking similarities between FND and post-concussion syndrome (including the "invisible" nature of symptoms and the "boom-bust" cycle). We dive deep into the role of occupational therapy in FND recovery, focusing on nervous system regulation, sensory integration, and the crucial "twist": focusing on the task, not the symptom.We discuss:A clear definition of FND and how it's diagnosed.The surprising overlap between FND, chronic pain, and concussion.Why a holistic, team-based approach (OT, PT, Psychology) is essential.Practical strategies for nervous system regulation and interoceptive awareness.Crucial advice for parents and caregivers on co-regulation and advocacy.What to do (and what not to do) during a functional seizure.School accommodations.A powerful message of hope: recovery is possible.If you or a loved one is navigating confusing neurological symptoms, this episode offers validation, clarity, and a roadmap to finding the right help.Shownotes & Key Resources Mentioned:Resources from Jason Kreuzman:RewireOT.com: Jason's central hub for FND resources, information, and updates on his outpatient clinic (opening late 2025).FND Society: Jason is the Co-Chair of their Pediatric Committee. The society offers lectures, research, and (with membership) a provider referral list. FNDSociety.orgEssential FND Information Hubs:Neurosymptoms.org: The "gold standard" patient education website, created and maintained by leading FND neurologists and researchers. An indispensable first stop for understanding the diagnosis.Patient-Led Advocacy & Support Groups: Jason highlights the incredible work of groups like FND Hope, FND What Now, and FND Action. These global communities provide connection, support, and resources.Tool for Management:Neuro-Log.com: A symptom management and tracking app created by a person with FND. A fantastic tool for identifying patterns and triggers in daily life.Guest Contact:Follow Jason's work and access resources at RewireOT.com.The Concussion Coach:Download the free guide, "5 Best Ways to Support Your Loved One Dealing with a Concussion," or book a free consultation with Bethany  at theconcussioncoach.com.

Dr. Jeff Ratliff talks with Dr. Dara Albert about the misconceptions surrounding FND, the importance of compassionate communication with patients, and the need for improved educational strategies to address knowledge gaps.  Read the related article in Neurology® Education.   Disclosures can be found at Neurology.org. 

Learn how The Running Man is comparable to a salad Vin made for Thanksgiving.  FND's LinksDISCORD - https://discord.gg/pX9JhgenPYINSTAGRAM - https://bit.ly/3Txr4IjSupport the show

Simone Round shares how a hand tremor evolved into a complex FND diagnosis, now consisting of tics, chronic migraines, non‑epileptic seizures, and the reality of becoming an ambulant wheelchair user. In this episode, Simone talks us through her journey from an active lifestyle and career, working over 70 hours a week, to the steps she now takes to support her mental health and wellbeing. She explains how she now takes pleasure in a much slower pace of life, mindfulness and connection with people who also live with chronic illness.Simone also describes the differences between carers and PAs and how her independence feels restored since having the aid of one. If you are concerned about any of the subjects discussed in the podcast, please follow up and seek support from your healthcare practitioner.For support:Visit your Healthcare practitionerFND Hope InternationalFND Hope UKFND Action UKFND IrelandFND Matters Northern IrelandFND Hope Canada & USA Facebook support pageHosted by Chantal Boyle, Hidden Disabilities Sunflower. If you enjoyed this podcast, please leave a rating and review. Find out more about the Sunflower by visiting the website hdsunflower.comMusic by "The Emerald Ruby" Emerald Ruby Bandcamp and Emerald Ruby website

Join Smark and Boxman for your weekly unfiltered deep dive into the world of pro wrestling!This week, we're cutting through the noise and breaking down the biggest headlines and drama, from Tony Khan's candid interview to the final predictions for AEW's final pay-per-view of the year:Tony Khan on Helwani: We analyze the highlights of the AEW CEO's must-hear interview on "The Ariel Helwani Show" (11-18-25)—did TK finally clear the air, or just add more mystery?AEW's Expanding Empire: All the details on AEW's new trademark filings and the huge announcement of new tour dates, including a highly anticipated return to NYC's Hammerstein Ballroom!Wrestling & The Law: What is the real story behind the K & S WrestleFest promoter and Bill Goldberg? We separate fact from rumor on the controversial walkout story.An Emotional Announcement: We send our love and discuss the brave announcement from AEW Wrestler Rebel (Tanea Brooks) revealing her cancer diagnosis and FND battle.Performance Center Power: WWE has added a massive new recruit! We talk about the signing of Nebraska Track and Field star Meghan Walker to a NXT/Performance Center deal.Vampire Cop Punk: Check out the trailer for the new horror movie "Night Patrol," starring CM Punk as a vampire-hunting LAPD officer! We give our initial thoughts on The Best in the World's latest acting gig.Full Gear 2025 Predictions: It's the moment of truth! Smark and Boxman run through the entire card to give their comprehensive AEW Full Gear (2025) predictions.Bonus Non-Wrestling Wildness: We can't resist a few bizarre headlines, including the Serial Brooklyn dine-and-dash influencer finally caught on camera and whether Bill Ackman is really here to help with your dating troubles.Tune in for the unfiltered takes and analysis you can only get from Smark and Boxman! Check us out live every Thursday at 9:30 PM ELive on YouTube: https://www.youtube.com/@wrestlingoutletpodApple Podcasts: https://podcasts.apple.com/us/podcast/dirt-sheet-dudes/id1471552947?uo=4Google Podcasts: https://www.google.com/podcasts?feed=aHR0cHM6Ly93d3cuc3ByZWFrZXIuY29tL3Nob3cvMzYwMzg2NS9lcGlzb2Rlcy9mZWVkFacebook: https://www.facebook.com/wrestlingoutlet/Twitter: @wrestlingoutletEmail: wrestlingoutletpod@gmail.comTotally Inappropriate Team Sports - https://www.youtube.com/@TotallyInappropriateTeamSports 

Imagine your brain's hardware is perfect, but the software is glitching so badly your body stops working.We sit down with Erum, a biochemist who navigates the world with a rare and often misunderstood condition: Functional Neurological Disorder (FND). We Raw Dog into the fascinating science behind the diagnosis. Basically her brain has a "software glitch" but the hardware is pristine. So how, and why is it causing the left side of her body to physically fail during flare-ups? Erum shares her harrowing and resilient story, from a terrifying ER visit where doctors suspected a brain tumor or MS, to the "magic trick" test that finally led to her FND diagnosis. We discuss the profound connection between her condition and a history of severe childhood trauma, including growing up as a child of deaf adults (CODA) and surviving abuse. Plus, we talk about the healing power of boxing and how FND finally forced her to stop people-pleasing.You can watch this entire episode over on YouTube!Follow Sickboy on Instagram, TikTok and Discord.

Imagine your brain's hardware is perfect, but the software is glitching so badly your body stops working.We sit down with Erum, a biochemist who navigates the world with a rare and often misunderstood condition: Functional Neurological Disorder (FND). We Raw Dog into the fascinating science behind the diagnosis. Basically her brain has a "software glitch" but the hardware is pristine. So how, and why is it causing the left side of her body to physically fail during flare-ups? Erum shares her harrowing and resilient story, from a terrifying ER visit where doctors suspected a brain tumor or MS, to the "magic trick" test that finally led to her FND diagnosis. We discuss the profound connection between her condition and a history of severe childhood trauma, including growing up as a child of deaf adults (CODA) and surviving abuse. Plus, we talk about the healing power of boxing and how FND finally forced her to stop people-pleasing.You can watch this entire episode over on YouTube!Follow Sickboy on Instagram, TikTok and Discord.

Merry Bingemas, one and all! Jodi Walker is back with 12 Days of Bingemas on Ringer Dish and the Ringer TV YouTube channel. Every Monday and Thursday until Christmas, Jodi will meet cute with all your Ringer faves to talk about the wildest plots, most mysterious Santa Claus–esque men, fakest towns, and chastest kisses in this year's original holiday movies. Fnd the weekly schedule at instagram.com/wereobsessedpod. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Dr. Joe Tafur and Natasha Pentin spoke with Canadian adult and pediatric neurologist Dr. Evan Cole Lewis to explore how epilepsy, trauma, and brain networks intertwine. We discuss pediatric epilepsy, cannabis for seizures, Functional Neurological Disorders (FND), and emerging psychedelic-assisted therapy treatments. Dr. Lewis talks about the differences between structural brain injury and brain “software” disruption, shining light on the world of trauma-based neurological symptoms. Dr. Lewis holds a clinical appointment as Adjunct Assistant Professor in the Department of Pediatrics at the Hospital for Sick Children and at the University of Toronto. Currently practicing at North Toronto Neurology and Homeward Therapy, Dr. Lewis focuses on epilepsy, brain injury, concussion and post-concussion symptoms, functional neurological disorders, and the therapeutic use of cannabis and psychedelics in these conditions.You can see more of Dr. Lewis's work here:  YouTube Website North Toronto Neurology Psychedelic Therapy (Homeward Therapy - coming soon). Newly published textbook for real-world medical cannabis prescribing, that Dr. Lewis conceived and edited with support of Medical Cannabis Clinicians Society. Designed for physicians, nurse practitioners, and healthcare educators. Case report mentioned (36:28)   For Dr. Joe Tafur's newsletter and Patreon: https://www.modernspirit.org/patreon Timestamps: (00:00) Introduction and Dr. Lewis's Background(01:57) WeCann Conference Meeting(04:16) Cannabis for Pediatric Epilepsy(05:47) Success Stories with Cannabis(9:30) Harm-Reduction Approach & Opening a Clinic(12:40) Medication for Different Types of Seizures (15:33) Psychedelics Treatment & Brain Networks(18:58) Functional Neurological Disorders (FND) & Non-Epileptic Seizures (22:19) The Brain's Structure vs Software (23:44) Diagnosing FND(29:19) Concussion and FND(33:55) Psychedelics and Brain Network Disruption(36:01) FND Also Rooted in Trauma Rather Than Physical Injury(39:44) Bridging Neurology and Psychology(45:08) Challenges and Risks of Psychedelic Treatments(54:54) Importance of Medical Education in Psychedelics(01:01:57) Future Projects and Research Initiatives

In this Dialogue episode of The Synopsis, we discuss Axon's and Floor & Decor's 3Q25 earnings.  AXON 3Q25 Business Update  Floor & Decor 3Q25 Business Update  This update quoted several expert call transcripts from Alpha Sense. You can get a free trial to read them for yourselve through this link.  ~*~ For full access to all of our updates and in-depth research reports become a Speedwell Member here. Please reach out to info@speedwellresearch.com if you need help getting us to become an approved research vendor in order to expense it. -*-*-*-*-*-*-*-*-*-*-*-*-*-*- Show Notes (0:00)  — Intro (2:10)  — Axon 3Q25 Update (13:50)  — Axon 911 Push (18:08)  — Axon Enterprise Call Option (22:20)  — Axon Valuation (30:00)  — Floor & Decor 3Q25 Update (38:24)  — FND Valuation (53:47)  — Outro -*-*-*-*-*-*-*-*-*-*-*-*-*-*- For full access to all of our updates and in-depth research reports, become a Speedwell Member here. Please reach out to info@speedwellresearch.com if you need help getting us to become an approved research vendor in order to expense it. *-*-*- Follow Us: Twitter: @Speedwell_LLC Threads: @speedwell_research Email us at info@speedwellresearch.com for any questions, comments, or feedback. -*-*-*-*-*-*-*-*-*-*- Disclaimer Nothing in this podcast is investment advice nor should be construed as such. Contributors to the podcast may own securities discussed. Furthermore, accounts contributors advise on may also have positions in companies discussed. At the time of publication, one or more contributors to this report has a position in FND and AXON. Furthermore, accounts one or more contributors advise on may also have a position in FND and AXON. This may change without notice. Please see our full disclaimers here:  https://speedwellresearch.com/disclaimer/

Dr Sumeet Singhal is a consultant neurologist, working at Nottingham University Hospitals NHS Foundation Trust. He is an FND expert and discusses presentations of FND. 

Tamra and Dolores break down the RHOBH trailer that just dropped. Fnd out Dolores’ theory behind why no one calls Mary Cosby out. Plus, Tamra compares Meredith Marks to Heather Dubrow. What do they have in common?! See omnystudio.com/listener for privacy information.

Despite what the CPR doll might suggest, cardiac arrest patients are not always white, lean and male. So why is that the case for resuscitation training? The first paper in this episode addresses this lack of representation and the impact it has on resus performance. The next paper is a practice review of functional neurological disorder (FND), highlighting the poor diagnosis rate and history keeping for this condition, as well as offering ways to communicate with patients. There's also a paper on the dilemma of febrile infants with concurrent viral and bacterial infections, and another on aeromedical service sedation protocols in the Australian Outback.   Read the highlights: November 2025 primary survey We need to talk about Annie Diversity of CPR manikins for basic life support education: use of manikin sex, race and body shape — a scoping review Recognising and managing functional neurological disorder in the acute healthcare setting Prevalence of serious bacterial infections and performance of inflammatory markers in febrile infants with and without proven viral illness Risk of complications using a sedation protocol for aeromedical retrieval of acutely unwell mental health patients: a retrospective cohort study in Outback Australia   The EMJ podcast is hosted by: Prof. Richard Body, EMJ Deputy Editor, University of Manchester, UK (@richardbody) Dr. Sarah Edwards, EMJ Senior Associate Editor and Social Media Editor, Royal Derby Hospital, UK (@drsarahedwards) You can subscribe to the EMJ podcast on all podcast platforms to get the latest podcast every month. If you enjoy our podcast, please consider leaving us a review or a comment on the EMJ Podcast Apple (https://apple.co/4bfcMU0) or Spotify (https://spoti.fi/3ufutSL) page.

Welcome to PsychEd, the psychiatry podcast for medical learners, by medical learners.This episode covers Functional Neurological Disorder with Dr. Patricia Rosebush. Dr. Rosebush is a Professor in the Department of Psychiatry & Behavioural Neurosciences at McMaster University. She is the distinguished author of numerous articles on clinical neuroscience, including considerable work on mitochondrial disorders in mental illness and over 30 papers on catatonia, and practices consultation-liaison psychiatry at St. Joseph's Healthcare Hamilton.The learning objectives for this episode are as follows:Provide a definition and conceptual approach to FNDIdentify clinical signs and patient histories relevant to a diagnosis of FNDDescribe an approach to the treatment of FNDUnderstand the special challenges of communication and collaboration in this illnessGuest: Dr. Patricia RosebushHosts: Dr. Alastair Morrison, Dr. Kate BraithwaiteAudio editing: Dr. Alastair MorrisonShow notes: Dr. Kate BraithwaiteInterview content:(02:39) Learning objectives(03:09) Conceptualization of FND(08:30) Underlying psychological processes(09:35) Difference between FND and factitious disorder/malingering(14:54) Alexithymia(16:51) Common symptomatic presentations(18:00) Types of underlying stressors(19:17) Other risk factors for FND(22:12) Communicating with patients to address stigma(24:32) Psychotherapy in FND(29:36) Referral pathways for patients with FND(31:15) Prognosis of FND(33:09) Social media and FNDResources:Functional Neurological Disorder Society. Functional Neurological Disorder Society (FNDS). Includes a podcast and courses for physiciansFunctional Neurological Disorder (FND) – A Patient's Guide to FNDReferences:Hull, M., & Parnes, M. (2021). Tics and TikTok: Functional Tics Spread Through Social Media. Movement disorders clinical practice, 8(8), 1248–1252. https://doi.org/10.1002/mdc3.13267National Institute for Neurological Disorders and Stroke. (2024, July.) Functional Neurological Disorder.  U.S. Department of Health and Human Services, National Institutes of Health. Functional Neurologic Disorder | National Institute of Neurological Disorders and StrokePsychDB. (2024, April). Conversion Disorder (Functional Neurological Disorder. Conversion Disorder (Functional Neurological Disorder) - PsychDBRosebush, P. I., & Mazurek, M. F. (2011). Treatment of conversion disorder in the 21st century: have we moved beyond the couch?. Current treatment options in neurology, 13(3), 255–266. https://doi.org/10.1007/s11940-011-0124-yScamvougeras, A., & Castle, D. (2024). Functional Neurological Disorders: Challenging the Mainstream Agnostic Causative Position. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 69(7), 487–492. https://doi.org/10.1177/07067437241245957For more PsychEd, follow us on Instagram (@psyched.podcast),  Facebook (PsychEd Podcast), X (@psychedpodcast), and Bluesky (@psychedpodcast.bsky.social‬). You can email us at psychedpodcast@gmail.com and visit our website at psychedpodcast.org.

Vin and Aaron list off some of their favorite scary movies!  This list is NOT given in a ranked order and the list is MUTABLE.  The list may at any point be updated with or without notice.  FND's LinksDISCORD - https://discord.gg/pX9JhgenPYPATREON - https://www.patreon.com/c/fndfilmsINSTAGRAM - https://bit.ly/3Txr4IjSupport the show

Welcome back to Before You Bloom. In today's episode, I'm joined by Chris, who lives with Functional Neurological Disorder (FND), a condition that disrupts how the brain sends and receives signals to the body. Often misunderstood and misdiagnosed, FND can impact every part of life, from physical movement to emotional wellbeing, yet it remains one of the least talked-about neurological conditions.Chris bravely shares his story to shed light on what it's really like to live with FND, the challenges, the misconceptions, and the small victories that come with navigating such a complex condition. We talk about the journey to diagnosis, the impact on identity and relationships, and the tools Chris uses to care for both his physical and mental health.This conversation is an eye-opening reminder of the resilience it takes to live with an invisible illness and the importance of compassion, understanding, and advocacy.Chris's honesty and courage will leave you with a deeper awareness of FND and a greater appreciation for the power of sharing our stories!⭐ ⭐ Download My Symptom Tracker and Mental Health Tracker Bundle (SAVE $$$) : HERE or if you would like to download them individually you can access here : Symptom Tracker OR Mental Health Tracker ⭐ ⭐

Meme stocks, those companies that individuals love to speculate with, are roaring back in 2025. So much so that the Meme Stock ETF is coming back after being discontinued in 2023. Today's show breaks down how much staying power the meme stock ETF will have this time around. Also, we review Ferrari's less-than-stellar guidance for the next several years and cover stocks on our radar. Tyler Crowe, Matt Frankel, and Jon Quast discuss: - Ferrari's decision to pare its electric vehicle lineup and its lower 2030 financial guidance - Roundhill Investment's decision to relaunch the Meme Stock ETF - Stocks on our radar Companies discussed: RACE, TSLA, GM, LVMH.F, HESAY, RH, HOOD, SOUN, OKLO, BE, TGT, FSLR, FND, HD, LOW Host: Tyler Crowe Guests: Matt Frankel, Jon Quast Engineer: Dan Boyd Disclosure: Advertisements are sponsored content and provided for informational purposes only. The Motley Fool and its affiliates (collectively, “TMF”) do not endorse, recommend, or verify the accuracy or completeness of the statements made within advertisements. TMF is not involved in the offer, sale, or solicitation of any securities advertised herein and makes no representations regarding the suitability, or risks associated with any investment opportunity presented. Investors should conduct their own due diligence and consult with legal, tax, and financial advisors before making any investment decisions. TMF assumes no responsibility for any losses or damages arising from this advertisement. We're committed to transparency: All personal opinions in advertisements from Fools are their own. The product advertised in this episode was loaned to TMF and was returned after a test period or the product advertised in this episode was purchased by TMF. Advertiser has paid for the sponsorship of this episode. Learn more about your ad choices. Visit ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices

Functional movement disorders are a common clinical concern for neurologists. The principle of “rule-in” diagnosis, which involves demonstrating the difference between voluntary and automatic movement, can be carried through to explanation, triage, and evidence-based multidisciplinary rehabilitation therapy. In this episode, Gordon Smith, MD, FAAN speaks Jon Stone, PhD, MB, ChB, FRCP, an author of the article “Multidisciplinary Treatment for Functional Movement Disorder” in the Continuum® August 2025 Movement Disorders issue. Dr. Smith is a Continuum® Audio interviewer and a professor and chair of neurology at Kenneth and Dianne Wright Distinguished Chair in Clinical and Translational Research at Virginia Commonwealth University in Richmond, Virginia. Dr. Stone is a consultant neurologist and honorary professor of neurology at the Centre for Clinical Brain Sciences at the University of Edinburgh in Edinburgh, United Kingdom. Additional Resources Read the article: Multidisciplinary Treatment for Functional Movement Disorder Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @gordonsmithMD Guest: @jonstoneneuro Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. This exclusive Continuum Audio interview is available only to you, our subscribers. We hope you enjoy it. Thank you for listening. Dr Smith: Hello, this is Dr Gordon Smith. Today I've got the great pleasure of interviewing Dr Johnstone about his article on the multidisciplinary treatment for functional neurologic disorder, which he wrote with Dr Alan Carson. This article will appear in the August 2025 Continuum issue on movement disorders. I will say, Jon, that as a Continuum Audio interviewer, I usually take the interviews that come my way, and I'm happy about it. I learn something every time. They're all a lot of fun. But there have been two instances where I go out and actively seek to interview someone, and you are one of them. So, I'm super excited that they allowed me to talk with you today. For those of our listeners who understand or are familiar with FND, Dr Stone is a true luminary and a leader in this, both in clinical care and research. He's also a true humanist. And I have a bit of a bias here, but he was the first awardee of the Ted Burns Humanism in Neurology award, which is a real honor and reflective of your great work. So welcome to the podcast, Jon. Maybe you can introduce yourself to our audience. Dr Stone: Well, thank you so much, Gordon. It was such a pleasure to get that award, the Ted Burns Award, because Ted was such a great character. I think the spirit of his podcasts is seen in the spirit of these podcasts as well. So, I'm a neurologist in Edinburgh in Scotland. I'm from England originally. I'm very much a general neurologist still. I still work full-time. I do general neurology, acute neurology, and I do two FND clinics a week. I have a research group with Alan Carson, who you mentioned; a very clinical research group, and we've been doing that for about 25 years. Dr Smith: I really want to hear more about your clinical approach and how you run the clinic, but I wonder if it would be helpful for you to maybe provide a definition. What's the definition of a functional movement disorder? I mean, I think all of us see these patients, but it's actually nice to have a definition. Dr Stone: You know, that's one of the hardest things to do in any paper on FND. And I'm involved with the FND society, and we're trying to get together a definition. It's very hard to get an overarching definition. But from a movement disorder point of view, I think you're looking at a disorder where there is an impairment of voluntary movement, where you can demonstrate that there is an automatic movement, which is normal in the same movement. I mean, that's a very clumsy way of saying it. Ultimately, it's a disorder that's defined by the clinical features it has; a bit like saying, what is migraine? You know? Or, what is MS? You know, it's very hard to actually say that in a sentence. I think these are disorders of brain function at a very broad level, and particularly with FND disorders, of a sort of higher control of voluntary movement, I would say. Dr Smith: There's so many pearls in this article and others that you've written. One that I really like is that this isn't a diagnosis of exclusion, that this is an affirmative diagnosis that have clear diagnostic signs. And I wonder if you can talk a little bit about the diagnostic process, arriving at an FND diagnosis for a patient. Dr Stone: I think this is probably the most important sort of “switch-around” in the last fifteen, twenty years since I've been involved. It's not new information. You know, all of these diagnostic signs were well known in the 19th century; and in fact, many of them were described then as well. But they were kind of lost knowledge, so that by the time we got to the late nineties, this area---which was called conversion disorder then---it was written down. This is a diagnosis of exclusion that you make when you've ruled everything out. But in fact, we have lots of rule in signs, which I hope most listeners are familiar with. So, if you've got someone with a functional tremor, you would do a tremor entrainment test where you do rhythmic movements of your thumb and forefinger, ask the patient to copy them. It's very important that they copy you rather than make their own movements. And see if their tremor stops briefly, or perhaps entrains to the same rhythm that you're making, or perhaps they just can't make the movement. That might be one example. There's many examples for limb weakness and dystonia. There's a whole lot of stuff to learn there, basically, clinical skills. Dr Smith: You make a really interesting point early on in your article about the importance of the neurological assessment as part of the treatment of the patient. I wonder if you could talk to our listeners about that. Dr Stone: So, I think, you know, there's a perception that- certainly, there was a perception that that the neurologist is there to make a diagnosis. When I was training, the neurologist was there to tell the patient that they didn't have the kind of neurological problem and to go somewhere else. But in fact, that treatment process, when it goes well, I think begins from the moment you greet the patient in the waiting room, shake their hand, look at them. Things like asking the patient about all their symptoms, being the first doctor who's ever been interested in their, you know, horrendous exhaustion or their dizziness. You know, questions that many patients are aware that doctors often aren't very interested in. These are therapeutic opportunities, you know, as well as just taking the history that enable the patient to feel relaxed. They start thinking, oh, this person's actually interested in me. They're more likely to listen to what you've got to say if they get that feeling off you. So, I'd spend a lot of time going through physical symptoms. I go through time asking the patient what they do, and the patients will often tell you what they don't do. They say, I used to do this, I used to go running. Okay, you need to know that, but what do they actually do? Because that's such valuable information for their treatment plan. You know, they list a whole lot of TV shows that they really enjoy, they're probably not depressed. So that's kind of useful information. I also spend a lot of time talking to them about what they think is wrong. Be careful, that they can annoy patients, you know. Well, I've come to you because you're going to tell me what's wrong. But what sort of ideas had you had about what was wrong? I need to know so that I can deal with those ideas that you've had. Is there a particular reason that you're in my clinic today? Were you sent here? Was it your idea? Are there particular treatments that you think would really help you? These all set the scene for what's going to come later in terms of your explanation. And, more importantly, your triaging of the patient. Is this somebody where it's the right time to be embarking on treatment, which is a question we don't always ask yourself, I think. Dr Smith: That's a really great point and kind of segues to my next question, which is- you talked a little bit about this, right? Generally speaking, we have come up with this is a likely diagnosis earlier, midway through the encounter. And you talked a little bit about how to frame the encounter, knowing what's coming up. And then what's coming up is sharing with the patient our opinion. In your article, you point out this should be no different than telling someone they have Parkinson's disease, for instance. What pearls do you have and what pitfalls do you have in how to give the diagnosis? And, you know, a lot of us really weren't trained to do this. What's the right way, and what are the most common land mines that folks step on when they're trying to share this information with patients? Dr Stone: I've been thinking about this for a long time, and I've come to the conclusion that all we need to do with this disorder is stop being weird. What goes wrong? The main pitfall is that people think, oh God, this is FND, this is something a bit weird. It's in a different box to all of the other things and I have to do something weird. And people end up blurting out things like, well, your scan was normal or, you haven't got epilepsy or, you haven't got Parkinson's disease. That's not what you normally do. It's weird. What you normally do is you take a deep breath and you say, I'm sorry to tell you've got Parkinson's disease or, you have this type of dystonia. That's what you normally say. If you follow the normal- what goes wrong is that people don't follow the normal rules. The patient picks up on this. What's going on here? This doctor's telling me what I don't have and then they're starting to talk about some reason why I've got this, like stress, even though I don't- haven't been told what it is yet. You do the normal rules, give it a name, a name that you're comfortable with, preferably as specific as possible: functional tremor, functional dystonia. And then do what you normally do, which is explain to the patient why you think it's this. So, if someone's got Parkinson's, you say, I think you've got Parkinson's because I noticed that you're walking very slowly and you've got a tremor. And these are typical features of Parkinson. And so, you're talking about the features. This is where I think it's the most useful thing that you can do. And the thing that I do when it goes really well and it's gone badly somewhere else, the thing I probably do best, what was most useful, is showing the patient their signs. I don't know if you do that, Gordon, but it's maybe not something that we're used to doing. Dr Smith: Wait, maybe you can talk more about that, and maybe, perhaps, give an example? Talk about how that impacts treatment. I was really impressed about the approach to physical therapy, and treatment of patients really leverages the physical examination findings that we're all well-trained to look for. So maybe explore that a little bit. Dr Stone: Yeah, I think absolutely it does. And I think we've been evolving these thoughts over the last ten or fifteen years. But I started, you know, maybe about twenty years ago, started to show people their tremor entrainment tests. Or their Hoover sign, for example; if you don't know Hoover sign, weakness of hip extension, that comes back to normal when the person's flexing their normal leg, their normal hip. These are sort of diagnostic tricks that we had. Ahen I started writing articles about FND, various senior neurologists said to me, are you sure you should write this stuff down? Patients will find out. I wrote an article with Marc Edwards called “Trick or Treat in Neurology” about fifteen years ago to say that actually, although they're they might seem like tricks, there really are treats for patients because you're bringing the diagnosis into the clinic room. It's not about the normal scan. You can have FND and MS. It's not about the normal scan. It's about what you're seeing in front of you. If you show that patient, yes, you can't move your leg. The more you try, the worse it gets. I can see that. But look, lift up your other leg. Let me show you. Can you see now how strong your leg is? It's such a powerful way of communicating to the patient what's wrong with them diagnostically, giving them that confidence. What it's also doing is showing them the potential for improvement. It's giving them some hope, which they badly need. And, as we'll perhaps talk about, the physio treatment uses that as well because we have to use a different kind of physio for many forms of functional movement disorder, which relies on just glimpsing these little moments of normal function and promoting them, promoting the automatic movement, squashing down that abnormal pattern of voluntary movement that people have got with FND. Dr Smith: So, maybe we can talk about that now. You know, I've got a bunch of other questions to ask you about mechanism and stuff, but let's talk about the approach to physical therapy because it's such a good lead-in and I always worry that our physical therapists aren't knowledgeable about this. So, maybe some examples, you have some really great ones in the article. And then words of wisdom for us as we're engaging physical therapists who may not be familiar with FND, how to kind of build that competency and relationship with the therapist with whom you work. Dr Stone: Some of the stuff is the same. Some of the rehabilitation ideas are similar, thinking about boom and bust activity, which is very common in these patients, or grading activity. That's similar, but some of them are really different. So, if you have a patient with a stroke, the physiotherapist might be very used to getting that person to think and look at their leg to try and help them move, which is part of their rehabilitation. In FND, that makes things worse. That's what's happening in Hoover sign and tremor entrainment sign. Attention towards the limb is making it worse. But if the patient's on board with the diagnosis and understands it, they'll also see what you need to do, then, in the physio is actively use distraction in a very transparent way and say to the patient, look, I think if I get you to do that movement, and I'll film you, I think your movement's going to look better. Wouldn't that be great if we could demonstrate that? And the patient says, yeah, that would be great. We're kind of actively using distraction. We're doing things that would seem a bit strange for someone with other forms of movement disorder. So, the patients, for example, with functional gait disorders who you discover can jog quite well on a treadmill. In fact, that's another diagnostic test. Or they can walk backwards, or they can dance or pretend that they're ice skating, and they have much more fluid movements because their ice skating program in their brain is not corrupted, but their normal walking program is. So, can you then turn ice skating or jogging into normal walking? It's not that complicated, I think. The basic ideas are pretty simple, but it does require some creativity from whoever's doing the therapy because you have to use what the patient's into. So, if the patient used to be a dancer- we had a patient who was a, she was really into ballet dancing. Her ballet was great, but her walking was terrible. So, they used ballet to help her walk again. And that's incredibly satisfying for the therapist as well. So, if you have a therapist who's not sure, there are consensus recommendations. There are videos. One really good success often makes a therapist want to do that again and think, oh, that's interesting. I really helped that patient get better. Dr Smith: For a long time, this has been framed as a mental health issue, conversion disorder, and maybe we can talk a little bit about early life of trauma as a risk factor. But, you know, listening to you talk, it sounds like a brain network problem. Even the word “functional”, to me, it seems a little judgmental. I don't know if this is the best term, but is this really a network problem? Dr Stone: The word “functional”, for most neurologists, sounds judgmental because of what you associate it with. If you think about what the word actually is, it's- it does what it says on the tin. There's a disordered brain function. I mean, it's not a great word. It's the least worst term, in my view. And yes, of course it's a brain network problem, because what other organ is it going to be? You know, that's gone wrong? When software brains go wrong, they go wrong in networks. But I think we have to be careful not to swing that pendulum too far to the other side because the problem here, when we say asking the question, is this a mental health problem or a neurological one, we're just asking the wrong question. We're asking a question that makes no sense. However you try and answer that, you're going to get a stupid answer because the question doesn't make sense. We shouldn't have those categories. It's one organ. And what's so fascinating about FND---and I hope what can incite your sort of curiosity about it---is this disorder which defies this categorization. You see some patients with it, they say, oh, they've got a brain network disorder. Then you meet another patient who was sexually abused for five years by their uncle when they were nine, between nine and fourteen; they developed an incredibly strong dissociative threat response into that experience. They have crippling anxiety, PTSD, interpersonal problems, and their FND is sort of somehow a part of that; part of that experience that they've had. So, to ignore that or to deny or dismiss psychological, psychiatric aspects, is just as bad and just as much a mistake as to dismiss the kind of neurological aspects as well. Dr Smith: I wonder if this would be a good time to go back and talk a little bit about a concept that I found really interesting, and that is FND as a prodromal syndrome before a different neurological problem. So, for instance, FND prodromal to Parkinson's disease. Can you talk to us a little bit about that? I mean, obviously I was familiar with the fact that patients who have nonepileptic seizurelike events often have epileptic seizures, but the idea of FND ahead of Parkinson's was new to me. Dr Stone: So, this is definitely a thing that happens. It's interesting because previously, perhaps, if you saw someone who was referred with a functional tremor---this has happened to me and my colleagues. They send me some with a functional tremor. By the time I see them, it's obvious they've got Parkinson's because it's been a little gap. But it turns out that the diagnosis of functional tremor was wrong. It was just that they've developed that in the prodrome of Parkinson's disease. And if you think about it, it's what you'd expect, really, especially with Parkinson's disease. We know people develop anxiety in the prodrome of Parkinson's for ten, fifteen years before it's part of the prodrome. Anxiety is a very strong risk factor for FND, and they're already developing abnormalities in their brain predisposing them to tremor. So, you put those two things together, why wouldn't people get FND? It is interesting to think about how that's the opposite of seizures, because most people with comorbidity of functional seizures and epilepsy, 99% of the time the epilepsy came first. They had the experience of an epileptic seizure, which is frightening, which evokes strong threat response and has somehow then led to a recapitulation of that experience in a functional seizure. So yeah, it's really interesting how these disorders overlap. We're seeing something similar in early MS where, I think, there's a slight excess of functional symptoms; but as the disease progresses, they often become less, actually. Dr Smith: What is the prognosis with the types of physical therapy? And we haven't really talked about psychological therapy, but what's the success rate? And then what's the relapse rate or risk? Dr Stone: Well, it does depend who they're seeing, because I think---as you said---you're finding difficult to get people in your institution who you feel are comfortable with this. Well, that's a real problem. You know, you want your therapists to know about this condition, so that matters. But I think with a team with a multidisciplinary approach, which might include psychological therapy, physio, OT, I think the message is you can get really good outcomes. You don't want to oversell this to patients, because these treatments are not that good yet. You can get spectacular outcomes. And of course, people always show the videos of those. But in published studies, what you're seeing is that most studies of- case series of rehabilitation, people generally improve. And I think it's reasonable to say to a patient, that we have these treatments, there's a good chance it's going to help you. I can't guarantee it's going to help you. It's going to take a lot of work and this is something we have to do together. So, this is not something you're going to do to the patient, they're going to do it with you. Which is why it's so important to find out, hey, do they agree with you with the diagnosis? And check they do. And is it the right time? It's like when someone needs to lose weight or change any sort of behavior that they've just become ingrained. It's not easy to do. So, I don't know if that helps answer the question. Dr Smith: No, that's great. And you actually got right where I was wanting to go next, which is the idea of timing and acceptance. You brought this up earlier on, right? So, sometimes patients are excited and accepting of having an affirmative diagnosis, but sometimes there's some resistance. How do you manage the situation where you're making this diagnosis, but a patient's resistant to it? Maybe they're fixating on a different disease they think they have, or for whatever reason. How do you handle that in terms of initiating therapy of the overall diagnostic process? Dr Stone: We should, you know, respect people's rights to have whatever views they want about what's wrong with them. And I don't see my job as- I'm not there to change everyone's mind, but I think my job is to present the information to them in a kind of neutral way and say, look, here it is. This is what I think. My experience is, if you do that, most people are willing to listen. There are a few who are not, but most people are. And most of the time when it goes wrong, I have to say it's us and not the patients. But I think you do need to find out if they can have some hope. You can't do rehabilitation without hope, really. That's what you're looking for. I sometimes say to patients, where are you at with this? You know, I know this is a really hard thing to get your head around, you've never heard of it before. It's your own brain going wrong. I know that's weird. How much do you agree with it on a scale of naught to ten? Are you ten like completely agreeing, zero definitely don't? I might say, are you about a three? You know, just to make it easy for them to say, no, I really don't agree with you. Patients are often reluctant to tell you exactly what they're thinking. So, make it easy for them to disagree and then see where they're at. If they're about seven, say, that's good. But you know, it'd be great if you were nine or ten because this is going to be hard. It's painful and difficult, and you need to know that you're not damaging your body. Those sort of conversations are helpful. And even more importantly, is it the right time? Because again, if you explore that with people, if a single mother with four kids and, you know, huge debts and- you know, it's going to be very difficult for them to engage with rehab. So, you have to be realistic about whether it's the right time, too; but keep that hope going regardless. Dr Smith: So, Jon, there's so many things I want to talk to you about, but maybe rather than let me drive it, let me ask you, what's the most important thing that our listeners need to know that I haven't asked you about? Dr Stone: Oh God. I think when people come and visit me, they sometimes, let's go and see this guy who does a lot of FND, and surely, it'll be so easy for him, you know? And I think some of the feedback I've had from visitors is, it's been helpful to watch, to see that it's difficult for me too. You know, this is quite hard work. Patients have lots of things to talk about. Often you don't have enough time to do it in. It's a complicated scenario that you're unravelling. So, it's okay if you find it difficult work. Personally, I think it's very rewarding work, and it's worth doing. It's worth spending the time. I think you only need to have a few patients where they've improved. And sometimes that encounter with the neurologist made a huge difference. Think about whether that is worth it. You know, if you do that with five patients and one or two of them have that amazing, really good response, well, that's probably worth it. It's worth getting out of bed in the morning. I think reflecting on, is this something you want to do and put time and effort into, is worthwhile because I recognize it is challenging at times, and that's okay. Dr Smith: That's a great number needed to treat, five or six. Dr Stone: Exactly. I think it's probably less than that, but… Dr Smith: You're being conservative. Dr Stone: I think deliberately pessimistic; but I think it's more like two or three, yeah. Dr Smith: Let me ask one other question. There's so much more for our listeners in the article. This should be required reading, in my opinion. I think that of most Continuum, but this, I really truly mean it. But I think you've probably inspired a lot of listeners, right? What's the next step? We have a general or comprehensive neurologist working in a community practice who's inspired and wants to engage in the proactive care of the FND patients they see. What's the next step or advice you have for them as they embark on this? It strikes me, like- and I think you said this in the article, it's hard work and it's hard to do by yourself. So, what's the advice for someone to kind of get started? Dr Stone: Yeah, find some friends pretty quick. Though, yeah, your own enthusiasm can take you a long way, you know, especially with we've got much better resources than we have. But it can only take you so far. It's really particularly important, I think, to find somebody, a psychiatrist or psychologist, you can share patients with and have help with. In Edinburgh, that's been very important. I've done all this work with the neuropsychiatrist, Alan Carson. It might be difficult to do that, but just find someone, send them an easy patient, talk to them, teach them some of this stuff about how to manage FND. It turns out it's not that different to what they're already doing. You know, the management of functional seizures, for example, is- or episodic functional movement disorders is very close to managing panic disorder in terms of the principles. If you know a bit about that, you can encourage people around you. And then therapists just love seeing these patients. So, yeah, you can build up slowly, but don't- try not to do it all on your own, I would say. There's a risk of burnout there. Dr Smith: Well, Dr Stone, thank you. You don't disappoint. This has really been a fantastic conversation. I really very much appreciate it. Dr Stone: That's great, Gordon. Thanks so much for your time, yeah. Dr Smith: Well, listeners, again, today I've had the great pleasure of interviewing Dr Jon Stone about his article on the multidisciplinary treatment for functional neurologic disorder, which he wrote with Dr Alan Carson. This article appears in the August 2025 Continuum issue on movement disorders. Please be sure to check out Continuum Audio episodes from this and other issues. And listeners, thank you once again for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. We hope you've enjoyed this subscriber-exclusive interview. Thank you for listening.

Investors looking at housing and homebuilders are probably wondering what to make of the seemingly contradictory messages out of the housing market. In this episode, Tyler, Matt, and Jon drill down into the confounding numbers in the housing market and some recent homebuilder earnings reports. Also, they react to Starbucks restructuring and serve up some stocks on their radar. Tyler Crowe, Matt Frankel, and Jon Quast discuss: - Starbucks unveils a $1 billion restructuring plan - The good, the bad, and the outlook for homebuilder stocks. - Stocks on our radar. Companies discussed: SBUX, CMG, KBH, LEN, MIAX, FND, TTD, ICE, SPGI, NDAQ, HD, LOW, AMZN, DHI Hosts: Tyler Crowe Guests: Matt Frankel, Jon Quast Engineer: Bart Shannon   Advertisements are sponsored content and provided for informational purposes only. The Motley Fool and its affiliates (collectively, "TMF") do not endorse, recommend, or verify the accuracy or completeness of the statements made within advertisements. TMF is not involved in the offer, sale, or solicitation of any securities advertised herein and makes no representations regarding the suitability, or risks associated with any investment opportunity presented. Investors should conduct their own due diligence and consult with legal, tax, and financial advisors before making any investment decisions. TMF assumes no responsibility for any losses or damages arising from this advertisement. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this week's episode, Brain & Life Podcast host Dr. Daniel Correa is joined by Tiffany Kairos, an epilepsy advocate and founder of the Epilepsy Network, and her husband Chris Kairos. Tiffany shares her journey of living with epilepsy and her recent diagnosis of Functional Neurologic Disorder (FND). Tiffany and Chris delve into their experience managing both conditions, the impact on daily life, and the support systems that help her navigate these experiences. Dr. Correa is then joined by Dr. W. Curt LaFrance, Inaugural Director of Neuropsychiatry and Behavioral Neurology at Rhode Island Hospital, Director of the VA Mind Brain program, and Professor of Psychiatry and Neurology at Brown University. Dr. LaFrance discusses the complexities of FND, the importance of integrating neurology and psychiatry for effective diagnosis and treatment, and the evolution of terminology to reduce stigma and improve patient engagement.   Additional Resources The Epilepsy Network (TEN) What is Functional Neurologic Disorder? Taking Control of Your Seizures Epilepsy Foundation The Anita Kaufman Foundation   Other Brain & Life Podcast Episodes on These Topics JenVon Cherry on Educating Communities of Color About Epilepsy Actor Cameron Boyce's Legacy and Raising Awareness About SUDEP Tiffany Kairos on Finding Her Voice in Epilepsy Advocacy   We want to hear from you! Have a question or want to hear a topic featured on the Brain & Life Podcast? ·       Record a voicemail at 612-928-6206 ·       Email us at BLpodcast@brainandlife.org   Social Media:   Guests: Tiffany Kairos @TiffanyKairos @theepilepsynetwork; Chris Kairos @ka1ro5; Dr. W. Curt LaFrance @brownuniversityhealth Hosts: Dr. Daniel Correa @neurodrcorrea; Dr. Katy Peters @KatyPetersMDPhD

Paroxysmal movement disorders refer to a group of highly heterogeneous disorders that present with attacks of involuntary movements without loss of consciousness. These disorders demonstrate considerable and ever-expanding genetic and clinical heterogeneity, so an accurate clinical diagnosis has key therapeutic implications. In this episode, Kait Nevel, MD, speaks with Abhimanyu Mahajan, MD, MHS, FAAN, author of the article “Paroxysmal Movement Disorders” in the Continuum® August 2025 Movement Disorders issue. Dr. Nevel is a Continuum® Audio interviewer and a neurologist and neuro-oncologist at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Mahajan is an assistant professor of neurology and rehabilitation medicine at the James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders at the University of Cincinnati in Cincinnati, Ohio. Additional Resources Read the article: Paroxysmal Movement Disorders Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @IUneurodocmom Guest: @MahajanMD Full episode transcript available here Dr Jones: This is Doctor Lyell Jones, editor in chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Nevel: Hello, this is Dr Kait Nevel. Today I'm interviewing doctor Abhi Mahajan about his article on diagnosis and management of paroxysmal movement disorders, which appears in the August 2025 Continuum issue on movement disorders. Abhi, welcome to the podcast and please introduce yourself to the audience. Dr Mahajan: Thank you, Kait. Thank you for inviting me. My name is Abhi Mahajan. I'm an assistant professor of neurology and rehabilitation medicine at the University of Cincinnati in Cincinnati, Ohio. I'm happy to be here. Dr Nevel: Wonderful. Well, I'm really excited to talk to you about your article today on this very interesting and unique set of movement disorders. So, before we get into your article a little bit more, I think just kind of the set the stage for the discussion so that we're all on the same page. Could you start us off with some definitions? What are paroxysmal movement disorders? And generally, how do we start to kind of categorize these in our minds? Dr Mahajan: So, the term paroxysmal movement disorders refers to a group of highly heterogeneous disorders. These may present with attacks of involuntary movements, commonly a combination of dystonia and chorea, or ataxia, or both. These movements are typically without loss of consciousness and may follow, may follow, so with or without known triggers. In terms of the classification, these have been classified in a number of ways. Classically, these have been classified based on the trigger. So, if the paroxysmal movement disorder follows activity, these are called kinesigenic, paroxysmal, kinesigenic dyskinesia. If they are not followed by activity, they're called non kinesigenic dyskinesia and then if they've followed prolonged activity or exercise they're called paroxysmal exercise induced dyskinesia. There's a separate but related group of protogynous movement disorders called episodic attacks here that can have their own triggers. Initially this was the classification that was said. Subsequent classifications have placed their focus on the ideology of these attacks that could be familiar or acquired and of course understanding of familiar or genetic causes of paroxysmal movement disorders keeps on expanding and so on and so forth. And more recently, response to pharmacotherapy and specific clinical features have also been introduced into the classification. Dr Nevel: Great, thank you for that. Can you share with us what you think is the most important takeaway from your article for the practicing neurologist? Dr Mahajan: Absolutely. I think it's important to recognize that everything that looks and sounds bizarre should not be dismissed as malingering. Such hyperkinetic and again in quotations, “bizarre movements”. They may appear functional to the untrained eye or the lazy eye. These movements can be diagnosed. Paroxysmal movement disorders can be diagnosed with a good clinical history and exam and may be treated with a lot of success with medications that are readily available and cheap. So, you can actually make a huge amount of difference to your patients' lives by practicing old-school neurology. Dr Nevel: That's great, thank you so much for that. I can imagine that scenario does come up where somebody is thought to have a functional neurological disorder but really has a proximal movement disorder. You mentioned that in your article, how it's important to distinguish between these two, how there can be similarities at times. Do you mind giving us a little bit more in terms of how do we differentiate between functional neurologic disorder and paroxysmal movement disorder? Dr Mahajan: So clinical differentiation of functional neurological disorder from paroxysmal movement disorders, of course it's really important as a management is completely different, but it can be quite challenging. There's certainly an overlap. So, there can be an overlap with presentation, with phenomenology. Paroxysmal nature is common to both of them. In addition, FND and PMD's may commonly share triggers, whether they are movement, physical exercise. Other triggers include emotional stimuli, even touch or auditory stimuli. What makes it even more challenging is that FND's may coexist with other neurological disorders, including paroxysmal movement disorders. However, there are certain specific phenom phenotypic differences that have been reported. So specific presentations, for example the paroxysms may look different. Each paroxysm may look different in functional neurological disorders, specific phenotypes like paroxysmal akinesia. So, these are long duration episodes with eyes closed. Certain kinds of paroxysmal hyperkinesia with ataxia and dystonia have been reported. Of course. More commonly we see PNES of paroxysmal nonepileptic spells or seizures that may be considered paroxysmal movement disorders but represent completely different etiology which is FND. Within the world of movement disorders, functional jerks may resemble propiospinal myoclonus which is a completely different entity. Overall, there are certain things that help separate functional movement disorders from paroxysmal movement disorders, such as an acute onset variable and inconsistent phenomenology. They can be suggestibility, distractibility, entrainment, the use of an EMG may show a B-potential (Bereitschaftspotential) preceding the movement in patients with FND. So, all of these cues are really helpful. Dr Nevel: Great, thanks. When you're seeing a patient who's reporting to these paroxysmal uncontrollable movements, what kind of features of their story really tips you off that this might be a proximal movement disorder? Dr Mahajan: Often these patients have been diagnosed with functional neurological disorders and they come to us. But for me, whenever the patient and or the family talk about episodic movements, I think about these. Honestly, we must be aware that there is a possibility that the movements that the patients are reporting that you may not see in clinic. Maybe there are obvious movement disorders. Specifically, there's certain clues that you should always ask for in the history, for example, ask for the age of onset, a description of movements. Patients typically have videos or families have videos. You may not be able to see them in clinic. The regularity of frequency of these movements, how long the attacks are, is there any family history of or not? On the basis of triggers, whether, as I mentioned before, do these follow exercise? Prolonged exercise? Or neither of the above? What is the presentation in between attacks, which I think is a very important clinical clue. Your examination may be limited to videos, but it's important not just to examine the video which represents the patient during an attack, but in between attacks. That is important. And of course, I suspect we'll get to the treatment, but the treatment can follow just this part, the history and physical exam. It may be refined with further testing, including genetic testing. Dr Nevel: Great. On the note of genetic testing, when you do suspect a diagnosis of paroxysmal movement disorder, what are some key points for the provider to be aware of about genetic testing? How do we go about that? I know that there are lots of different options for genetic testing and it gets complicated. What do you suggest? Dr Mahajan: Traditionally, things were a little bit easier, right, because we had a couple of genes that have been associated with the robust movement disorders. So, genetic testing included single gene testing, testing for PRRT2 followed by SLC2A. And if these were negative, you said, well, this is not a genetic ideology for paroxysmal movement disorders. Of course, with time that has changed. There's an increase in known genes and variants. There is increased genetic entropy. So, the same genetic mutation may present with many phenotypes and different genetic mutations may present with the similar phenotype. Single gene testing is not a high yield approach. Overall genetic investigations for paroxysmal movement disorders use next generation sequencing or whole exome sequence panels which allow for sequencing of multiple genes simultaneously. The reported diagnostic yield with let's say next generation sequencing is around 35 to 50 percent. Specific labs at centers have developed their own panels which may improve the yield of course. In children, microarray may be considered, especially the presentation includes epilepsy or intellectual disability because copy number variations may not be detected by a whole exome sequencing or next generation sequencing. Overall, I will tell you that I'm certainly not an expert in genetics, so whenever you're considering genetic testing, if possible, please utilize the expertise of a genetic counsellor. Families want to know, especially as an understanding of the molecular underpinnings and knowledge about associated mutations or variations keeps on expanding. We need to incorporate their expertise. A variant of unknown significance, which is quite a common result with genetic testing, may not be a variant of unknown significance next year may be reclassified as pathogenic. So, this is extremely important. Dr Nevel: Yeah. That's such a good point. Thank you. And you just mentioned that there are some genetic mutations that can lead to multiple different phenotypes. Seemingly similar phenotypes can be associated with various genetic mutations. What's our understanding of that? Do we have an understanding of that? Why there is this seeming disconnect at times between the specific genetic mutation and the phenotype? Dr Mahajan: That is a tough question to answer for all paroxysmal movement disorders because the answer may be specific to a specific mutation. I think a great example is the CACNA1A mutation. It is a common cause of episodic ataxia type 2. Depending on when the patient presents, you can have a whole gamut of clinical presentations. So, if the patient is 1 year old, the patient can present with epileptic encephalopathy. Two to 5 years, it can be benign paroxysmal torticollis of infancy. Five to 10 years, can present with learning difficulties with absence epilepsy and then of course later, greater than 10 years, with episodic ataxia (type) 2 hemiplegic migraine and then a presentation with progressive ataxia and hemiplegic migraines has also been reported. So not just episodic progressive form of ataxia has also been reported. I think overall these disorders are very rare. They are even more infrequently diagnosed than their prevalence. As such, the point that different genetic mutations present with different phenotypes, or the same genetic mutation I may present with different phenotypes could also represent this part. Understanding of the clinical presentation is really incomplete and forever growing. There's a new case report or case series every other month, which makes this a little bit challenging, but that's all the more reason for learning about them and for constant vigilance for patients who show up to our clinic. Dr Nevel: Yeah, absolutely. What is our current understanding of the associated pathophysiology of these conditions and the pathophysiology relating to the genetics? And then how does that relate to the treatment of these conditions? Dr Mahajan: So, a number of different disease mechanisms have been proposed. Traditionally, these were all thought to be ion channelopathies, but a number of different processes have been proposed now. So, depending on the genetic mutation that you talk about. So certain mutations can involve ion channels such as CACMA1A, ATP1A3. It can involve solute carriers, synaptic vesicle fusion, energy metabolism such as ECHS1, synthesis of neurotransmitters such as GCH1. So, there are multiple processes that may be involved. I think overall for the practicing clinician such as me, I think there is a greater need for us to understand the underlying genetics and associated phenotypes and the molecular mechanisms specifically because these can actually influence treatment decisions, right? So, you mentioned that specific genetic testing understanding of the underlying molecular mechanism can influence specific treatments. As an example, a patient presenting with proximal nocturnal dyskinesia with mutation in the ADCY5 gene may respond beautifully to caffeine. Other examples if you have SLC2A1, so gluc-1 (glucose transporter type 1) mutation, a ketogenic diet may work really well. If you have PDHA1 mutation that may respond to thiamine and so on and so forth. There are certain patients where paroxysmal movement disorders are highly disabling and you may consider deep brain stimulation. That's another reason why it may be important to understand genetic mutations because there is literature on response to DBS with certain mutations versus others. Helps like counselling for patients and families, and of course introduces time, effort, and money spent in additional testing. Dr Nevel: Other than genetic testing, what other diagnostic work up do you consider when you're evaluating patients with a suspected paroxysmal movement disorder? Are there specific things in the history or on exam that would prompt you to do certain testing to look for perhaps other things in your differential when you're first evaluating a patient? Dr Mahajan: In this article, I provide a flow chart that helps me assess these patients as well. I think overall the history taking and neurological exam outside of these paroxysms is really important. So, the clinical exam in between these episodic events, for example, for history, specific examples include, well, when do these paroxysms happen? Do they happen or are they precipitated with meals that might indicate that there's something to do with glucose metabolism? Do they follow exercise? So, a specific example is in Moyamoya disease, they can be limb shaking that follows exercise. So, which gives you a clue to what the etiology could be. Of course, family history is important, but again, talking about the exam in between episodes, you know, this is actually a great point because out– we've talked about genetics, we've talked about idiopathic paroxysmal movement disorders, –but a number of these disorders are because of acquired causes. Well, of course it's important because acquired causes such as autoimmune causes, so multiple sclerosis, ADEM, lupus, LGI1, all of these NMDAR, I mentioned Moyamoya disease and metabolic causes. Of course, you can consider FND as under-acquired as well. But all of these causes have very different treatments and they have very different prognosis. So, I think it's extremely important for us to look into the history with a fine comb and then examine these patients in between these episodes and keep our mind open about acquired causes as well. Dr Nevel: When you evaluate these patients, are you routinely ordering vascular imaging and autoimmune kind of serologies and things like that to evaluate for these other acquired causes or it does it really just depend on the clinical presentation of the patient? Dr Mahajan: It mostly depends on the clinical presentation. I mean, if the exam is let's say completely normal, there are no other risk factors in a thirty year old, then you know, with a normal exam, normal history, no other risk factors. I may not order an MRI of the brain. But if the patient is 55 or 60 (years) with vascular risk factors, then you have to be mindful that this could be a TIA. If the patient has let's say in the 30s and in between these episodes too has basically has a sequel of these paroxysms, then you may want to consider autoimmune. I think the understanding of paraneoplastic, even autoimmune disorders, is expanding as well. So, you know the pattern matters. So, if all of this is subacute started a few months ago, then I have a low threshold for ordering testing for autoimmune and paraneoplastic ideology is simply because it makes such a huge difference in terms of how you approach the treatment and the long-term prognosis. Dr Nevel: Yeah, absolutely. What do you find most challenging about the management of patients with paroxysmal movement disorders? And then also what is most rewarding? Dr Mahajan: I think the answer to both those questions is, is the same. The first thing is there's so much advancement in what we know and how we understand these disorders so regularly that it's really hard to keep on track. Even for this article, it took me a few months to write this article, and between the time and I started and when I ended, there were new papers to include new case reports, case series, right? So, these are rare disorders. So most of our understanding for these disorders comes from case reports and case series, and it's in a constant state of advancement. I think that is the most challenging part, but it's also the most interesting part as well. I think the challenging and interesting part is the heterogeneity of presentation as well. These can involve just one part of your body, your entire body can present with paroxysmal events, with multiple different phenomenologies and they might change over time. So overall, it's highly rewarding to diagnose such patients in clinic. As I said before, you can make a sizeable difference with the medication which is usually inexpensive, which is obviously a great point to mention these days in our health system. But with anti-seizure drugs, you can put the right diagnosis, you can make a huge difference. I just wanted to make a point that this is not minimizing in any way the validity or the importance of diagnosing patients with functional neurological disorders correctly. Both of them are as organic. The importance is the treatment is completely different. So, if you're diagnosing somebody with FND and they do have FND and they get cognitive behavioral therapy and they get better, that's fantastic. But if somebody has paroxysmal movement disorders and they undergo cognitive behavioral therapy and they're not doing well, that doesn't help anybody. Dr Nevel: One hundred percent. As providers, obviously we all want to help our patients and having the correct diagnosis, you know, is the first step. What is most interesting to you about paroxysmal movement disorders? Dr Mahajan: So outside of the above, there are some unanswered questions that I find very interesting. Specifically, the overlap with epilepsy is very interesting, including shared genes, the episodic nature, presence of triggers, therapeutic response to anti-seizure drugs. All of this I think deserves further study. In the clinic, you may find that epilepsy and prognosis for movement disorders may occur in the same individual or in a family. Episodic ataxia has been associated with seizures. Traditionally this dichotomy of an ictal focus. If it's cortical then it's epilepsy, if it's subcortical then it's prognosis for movement disorders. This is thought to be overly simplistic. There can be co-occurrence of seizures and paroxysmal movement disorders in the same patient and that has led to this continuum between these two that has been proposed. This is something that needs to be looked into in more detail. Our colleagues in Epilepsy may scoff this, but there's concept of basal ganglia epilepsy manifesting as paroxysmal movement disorders was proposed in the past. And there was this case report that was published out of Italy where there was ictal discharge from the supplementary sensory motor cortex with a concomitant discharge from the ipsilateral coordinate nucleus in a patient with paroxysmal kinesigenic cardioarthidosis. So again, you know, basal ganglia epilepsy, no matter what you call it, the idea is that there is a clear overlap between these two conditions. And I think that is fascinating. Dr Nevel: Really interesting stuff. Well, thank you so much for chatting with me today. Dr Mahajan: Thank you, Kait. And thank you to the Continuum for inviting me to write this article and for this chance to speak about it. I'm excited about how it turned out, and I hope readers enjoy it as well. Dr Nevel: Today again, I've been interviewing doctor Abhi Mahajan about his article on diagnosis and management of paroxysmal movement disorders, which appears in the August 2025 Continuum issue on movement disorders. I encourage all of our listeners to be sure to check out the Continuum Audio episodes from this and other issues. As always, please read the Continuum articles where you can find a lot more information than what we were able to cover in our discussion today. And thank you for our listeners for joining today. And thank you, Abhi, so much for sharing your knowledge with us today. Dr Monteith: This is Dr Teshamae Monteith, associate editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Disabled people are reporting that their Access To Work grants are being cut back, and at a time when the government is encouraging disabled people to get back into the workforce. As the ATW grant is awarded to help you hold down a job, or enable self-employment, it's causing confusion and concern. Disability correspondent Nikki Fox joins us to share her findings and what government is saying.The Bengsons are a joyous folk-rock duo from the US currently on a mini tour of the UK. They're both autistic, and their show Ohio fascinatingly plots the hearing loss of Sean, the male half of the two married musicians. You'll love their interview.Presenter Emma Tracey is joined by neurospicy comedian Juliette Burton to take the temperature of the disability stories floating around the internet this week.And British TikTok celeb Nathan Wedge joins Emma to talk about how his life changed after having 17 seizures, and a diagnosis of FND - functional neurological disorder. Formerly a dentist, is his body telling him he'll be able to go back to fixing peoples smiles?Say "Ask the BBC for Access All" to your smart speaker. It's dead easy. And search for us on BBC Sounds, and subscribe.Recorded and mixed by Dave O'Neill, PRODUCED by Emma Tracey and Damon Rose, the editor is Damon Rose. Email Emma now on accessall@bbc.co.uk - how's your news?

In this week's episode, we speak with Associate Professor Anna Miles and Adjunct Associate Professor Jan Baker about functional dysphagia. Jan and Anna talk about the research from FND that they have drawn on to create a biopsychosocial framework for supporting people with functional dysphagia. Resources:  Read Anna and Jan's article here: Miles, A., Baker, J., Barker-Collo, S., & Leadley, S. (2025). Functional dysphagia: Developing a framework for assessment and treatment. International journal of speech-language pathology, 1–16. Advance online publication. https://doi.org/10.1080/17549507.2025.2473071 For a full list of the references please go to the SPA Learning Hub (https://learninghub.speechpathologyaustralia.org.au/), you will need to sign in or create a free account. For more information, please see our Bio or for further enquiries, email speakuppodcast@speechpathologyaustralia.org.au SPA resources: SPA Dysphagia practice guideline: https://www.speechpathologyaustralia.org.au/resource?resource=125 SPA Mental health and trauma resources: https://www.speechpathologyaustralia.org.au/Public/Public/services/About-speech-pathologists/Mental-health-trauma.aspx Speech Pathology Australia acknowledge the Traditional Custodians of lands, seas and waters throughout Australia, and pay respect to Elders past and present. We recognise that the health and social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples are grounded in continued connection to culture, country, language and community and acknowledge that sovereignty was never ceded.  Free access to transcripts for podcast episodes are available via the SPA Learning Hub (https://learninghub.speechpathologyaustralia.org.au/), you will need to sign in or create an account. For more information, please see our Bio or for further enquiries, email speakuppodcast@speechpathologyaustralia.org.au Disclaimer: © (2025) The Speech Pathology Association of Australia Limited. All rights reserved. Important Notice, Please read: The views expressed in this presentation and reproduced in these materials are not necessarily the views of, or endorsed by, The Speech Pathology Association of Australia Limited (“the Association”). The Association makes no warranty or representation in relation to the content, currency or accuracy of any of the materials comprised in this recording. The Association expressly disclaims any and all liability (including liability for negligence) in respect of use of these materials and the information contained within them. The Association recommends you seek independent professional advice prior to making any decision involving matters outlined in this recording including in any of the materials referred to or otherwise incorporated into this recording. Except as otherwise stated, copyright and all other intellectual property rights comprised in the presentation and these materials, remain the exclusive property of the Association. Except with the Association's prior written approval you must not, in whole or part, reproduce, modify, adapt, distribute, publish or electronically communicate (including by online means) this recording or any of these materials.

The September 2025 Recall replay highlights four previously released episodes focused on epilepsy. Dr. Halley Alexander begins the series with Dr. Juan Luis Alcala-Zermeno, discussing outcomes of epilepsy surgery in patients with tonic-clonic seizures. She then speaks with Dr. Samuel W. Terman about patients' perceived seizure risk, seizure risk tolerance, and approaches to risk counseling. In the third episode, Dr. Alexander is joined by Dr. Vineet Punia to explore factors influencing the decision to continue or discontinue anti-seizure medications at discharge for patients hospitalized with acute symptomatic seizures. The replay concludes with Dr. Katie Krulisky's conversation with Dr. Leah Blank on how outpatient follow-up impacts readmission rates in older adults with epilepsy or seizures Podcast links:  The Effect of Epilepsy Surgery on Tonic–Clonic Seizures  Patient Perspectives on Antiseizure Medication Discontinuation  Understanding Acute Symptomatic Seizures    Outpatient Follow-Up With 30-Day Readmission After Epilepsy or Seizure Discharge  Article links:  The Effect of Epilepsy Surgery on Tonic–Clonic Seizures Patient Perspectives on Antiseizure Medication Discontinuation  Antiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures Association of Outpatient Follow-Up With 30-Day Readmission After Epilepsy or Seizure Discharge in Medicare Beneficiaries Aged 65 and Older   Disclosures can be found at Neurology.org. 

In this Dialogue episode of The Synopsis, Drew has a "dialogue" of one as he reviews 2Q25 earnings from Floor & Decor and Meta. You can find free versions of these updates below.  Meta 2Q25 Business Update  Floor & Decor 2Q25 Business Update If you want to get a free trial to access >200k AlphaSense expert call transcripts, you this link here.  ~*~ For full access to all of our updates and in-depth research reports become a Speedwell Member here. Please reach out to info@speedwellresearch.com if you need help getting us to become an approved research vendor in order to expense it. -*-*-*-*-*-*-*-*-*-*-*-*-*-*- Show Notes (0:00) — Intro (1:24) — Floor & Decor 2Q25 Update (16:07) — Meta 2Q25 Update  -*-*-*-*-*-*-*-*-*-*-*-*-*-*- For full access to all of our updates and in-depth research reports, become a Speedwell Member here. Please reach out to info@speedwellresearch.com if you need help getting us to become an approved research vendor in order to expense it. *-*-*- Follow Us: Twitter: @Speedwell_LLC Threads: @speedwell_research Email us at info@speedwellresearch.com for any questions, comments, or feedback. -*-*-*-*-*-*-*-*-*-*- Disclaimer Nothing in this podcast is investment advice nor should be construed as such. Contributors to the podcast may own securities discussed. Furthermore, accounts contributors advise on may also have positions in companies discussed. At the time of publication, one or more contributors to this report has a position in META and FND. Furthermore, accounts one or more contributors advise on may also have a position in META and FND. This may change without notice. Please see our full disclaimers here:  https://speedwellresearch.com/disclaimer/

Dr. Kathryn Krulisky and Dr. Jordan Garris discuss educational gaps in understanding FND, the impact of stigma on patient care, and the importance of empathy in medical training. Show reference: https://www.neurology.org/doi/10.1212/NE9.0000000000200219

Dr. Kathryn Krulisky and Dr. Jordan Garris discuss educational gaps in understanding FND, the impact of stigma on patient care, and the importance of empathy in medical training.  Show reference: https://www.neurology.org/doi/10.1212/NE9.0000000000200219 

Dr. Kathryn Krulisky talks with Dr. Jordan Garris about educational gaps in understanding FND, the impact of stigma on patient care, and the importance of empathy in medical training.  Read the related article in Neurology® Education.  Disclosures can be found at Neurology.org.   

Bear in Mind Ep. 17What happens when the body shuts down—but nothing shows up on a scan?This week, we explore Functional Neurological Symptom Disorder (FND)—a complex and often misunderstood condition that causes real symptoms like seizures, paralysis, or loss of speech, with no detectable neurological cause.Our guest, Dr. Curt LaFrance, double-boarded in psychiatry and neurology, helps break down what we do (and don't) know about FND. From diagnosis to treatment and stigma, we cover the science, the struggle, and the hope.

Governor DeWine signed Ohio’s $60 billion state budget, and the impact on families, schools, and values is massive. In this week's episode of The Narrative, CCV President Aaron Baer, Policy Director David Mahan, and Communications Director Mike Andrews break down what was included in the budget, what was vetoed, and how it all affects the fight for faith, freedom, and parental rights in Ohio. We celebrate major victories, including: ✅ No iGaming expansion—protecting families from the dangers of online gambling addiction and the insertion of VLTs in public spaces. ✅ The Innocence Act—protecting children from online porn and "deepfakes." ✅ Cell phone-free schools—supporting focus and healthy learning environments for Ohio's children. ✅ Medicaid accountability—ensuring taxpayer dollars won’t fund radical DEI agendas or harmful gender surgeries on minors. And we push back against the governor's vetoes on:

You asked. I answered. In this solo Q&A, I tackle some of the biggest and most misunderstood questions from our Bendy Bodies community. From toddlers flagged for autism to adults fighting for an EDS diagnosis, from altitude flares to functional neurologic disorder, this episode pulls no punches. I talk low-dose naltrexone (LDN), altitude hacks, medication struggles, and the quiet panic of a diagnosis that suddenly shifts under you. Plus, we look ahead to the 2026 hEDS (hypermobile Ehlers-Danlos Syndrome) classification changes and the stigma that still haunts hypermobile bodies. Whether you're a patient, a provider, or somewhere in between—you'll hear something in this episode that makes you feel seen. Takeaways: How the diagnosis of functional neurologic disorder (FND) is often misused—and what that means for bendy patients. What one family doctor learned when her toddler was flagged for autism... and EDS. The truth about low-dose naltrexone—and why it's not a quick fix. Why a change in your diagnosis doesn't change your reality. A life-saving strategy for traveling to high altitudes with EDS or POTS. Connect with YOUR Hypermobility Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/. Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them. Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/. YOUR bendy body is our highest priority! Use this affiliate link for Algonot to get an extra 5% off your entire order: https://algonot.com/coupon/bendbod/ Connect with the HypermobilityMD:  YouTube: ⁠youtube.com/@bendybodiespodcast⁠  Instagram: ⁠https://www.instagram.com/hypermobilitymd/⁠  Facebook: ⁠https://www.facebook.com/BendyBodiesPodcast⁠  X: ⁠https://twitter.com/BluesteinLinda⁠  LinkedIn: ⁠https://www.linkedin.com/in/hypermobilitymd/⁠  Newsletter: ⁠https://hypermobilitymd.substack.com/⁠ Shop my Amazon store ⁠https://www.amazon.com/shop/hypermobilitymd⁠ Learn more about Human Content at http://www.human-content.com Podcast Advertising/Business Inquiries: sales@human-content.com Part of the Human Content Podcast Network FTC: This video is not sponsored. Links are commissionable, meaning I may earn commission from purchases made through links. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Halley Alexander and Dr. Serena Yin discuss the effectiveness of an electronic medical record best practice alert in preventing iatrogenic interventions for patients with a diagnosis of PNES. Show references:  https://www.neurology.org/doi/10.1212/CPJ.0000000000200457 

Dr. Halley Alexander talks with Dr. Serena Yin about the effectiveness of an electronic medical record best practice alert in preventing iatrogenic interventions for patients with a diagnosis of psychogenic nonepileptic seizures. Read the related article in Neurology® Clinical Practice.  Disclosures can be found at Neurology.org. 

Ever consider specializing deeper into an aspect of neuro? Wonder what it's like to dive deep into a subset of the neuro population and sharpen your practice? In today's show, host Erin Gallardo, PT, DPT, NCS interviews Andrew Doubek, PT, DPT, GCS, NMD about his recent experience going through an accredited movement disorders fellowship program at the Ohio State. In the show we talk about the details of what the fellowship was like from the schedule, mix of experiences, requirements and types of patients. Andrew shares his insights and words of wisdom to anyone considering a fellowship.   Plus, with documentation efficiency being top of mind for so many clinicians, Andrew generously shares his handout of smart phrases crafted from the Clinical Practice Guidelines that you can plug into your assessments and progress notes to ensure you're targeting the key aspects needed in your notes in less time. Download the smart phrase guides here! PD CPG smartphrase.docx FND smartphrase.docx Core outcomes smart phrases.docx

In the final episode of this three-part series, Dr. Jodie Roberts and Dr. Urs Fisch discuss functional/dissociative seizures and driving risk.  Learn more about the Neurology® Practice Current section and fill out the current survey on functional/dissociative seizures and driving. 

In part two of this three-part series, Dr. Jodie Roberts and Dr. Barbara A. Dworetzky discuss how often seizure-like or seizure-resembling episodes lead to a diagnosis of functional neurologic disorder.  Learn more about the Neurology® Practice Current section and fill out the current survey on functional/dissociative seizures and driving. 

In part one of this three-part series, Dr. Jodie Roberts and Dr. Barbara A. Dworetzky discuss the term "functional seizures" and clarify the terminology.  Learn more about the Neurology® Practice Current section and fill out the current survey on functional/dissociative seizures and driving. 

Send us a text if you want to be on the Podcast & explain why!Become a QUALIFIED Certified personal trainer with www.showupfitness.comQualifying yourself as a professional personal trainer means going beyond basic certifications when working with clients who have complex conditions like Functional Neurological Disorder (FND). This episode breaks down exactly how to establish yourself as a trusted fitness professional within the medical community while designing effective programs for clients with neurological challenges.When working with clients who have medical conditions, your first move should always be reaching out directly to their healthcare providers. We walk you through exactly how to approach doctors and therapists, what to say, and how to present yourself as a qualified professional who stands apart from the Instagram fitness crowd. This simple step not only improves your programming but positions you for valuable referral relationships.For the long-distance runner with FND who experiences symptoms while descending stairs, we detail a comprehensive programming approach focusing on unilateral strength, frontal plane stability, and neurological control. You'll learn specific exercise selections—from explosive step-downs to airplane poses—that directly address the functional limitations while building overall performance. Most importantly, we explain why consistent progression of these movements creates better results than constantly changing exercises.The difference between average trainers and elite coaches isn't just exercise selection—it's creating comprehensive systems and networks. By learning to work collaboratively with medical professionals and focusing on evidence-based programming rather than entertainment, you'll not only help clients overcome conditions like FND, but you'll establish yourself as an indispensable part of their healthcare team. Ready to elevate your professional status and help clients who truly need your expertise?Want to ask us a question? Email email info@showupfitness.com with the subject line PODCAST QUESTION to get your question answered live on the show! Our Instagram: https://www.instagram.com/showupfitnessinternship/?hl=enTikTok: https://www.tiktok.com/@showupfitnessinternshipWebsite: https://www.showupfitness.com/Become a Personal Trainer Book (Amazon): https://www.amazon.com/How-Become-Personal-Trainer-Successful/dp/B08WS992F8Show Up Fitness Internship & CPT: https://online.showupfitness.com/pages/online-show-up?utm_term=show%20up%20fitnessNASM study guide: ...

Prof. Jon Stone talks with Dr. Laura Strom and Meagan Watson about changes in total emergency department and inpatient visits and costs before and after referral to a specialized, comprehensive functional seizure treatment clinic. Read the related article with Neurology® Clinical Practice. Disclosures can be found at Neurology.org.