When A Stroke Is Not A Stroke:

Today Functional Neurological Disorders Are Very Poorly Understood and Patients Are Not Receiving The Treatments That Are Available

What Is A Functional Neurological Disorder:

Functional Neurological Disorder (FND) represents one of neurology's most complex challenges, presenting with neurological symptoms that cannot be explained by traditional neurological conditions.

Patients may experience a range of symptoms mimicking stroke, including limb weakness, abnormal movements, non-epileptic seizures, and sensory deficits.

Unlike structural neurological conditions, FND shows functional or connectivity changes rather than anatomical or structural brain changes. This affects connectivity of neural networks controlling movement, emotion, and self-awareness and leads to a stroke like syndrome. 

Advances In Brain Imaging Show To The Loss Of Connectivity In FND:

Advances in brain imaging, especially functional MRI (fMRI), have transformed our understanding of this condition. These sophisticated imaging techniques have revealed altered connectivity patterns between brain networks and specific changes in areas controlling emotion and motor function. The imaging provides precise targeting for treatment modalities. This breakthrough has not only enhanced our understanding of FND but has also led to the development of more targeted and effective treatments. 

Three Advanced Treatments For Functional Neurological Disorders:

Neurofeedback Therapy:

Among the most promising new treatments is neurofeedback therapy, which combines EEG and fMRI guidance to help patients regain control over their neural patterns. Early studies show encouraging results, with 40-60% of patients experiencing significant symptom improvement. This approach allows patients to actively participate in their recovery by learning to regulate their brain activity patterns.

Psychedelic Assisted Therapy:

Psychedelic-assisted therapy has emerged as another innovative treatment option. Under careful medical supervision, psilocybin therapy has shown potential in enhancing neuroplasticity and improving the integration between emotional and physical symptoms. This groundbreaking approach is currently available through clinical trials at major Canadian centers, including CAMH Toronto, UBC, and McGill University Health Centre.

Repetitive Transcranial Magnetic Stimulation (rTMS)

This represents a third frontier in FND treatment. This non-invasive brain stimulation technique targets specific motor and sensory circuits, showing particular promise when combined with physical therapy. Clinical studies report a 40-60% success rate in improving motor symptoms, making it an increasingly important tool in the FND treatment arsenal.

RCM's Case Study:

Bill was 55 years of age. He was a senior manager at a bank. He developed sudden left sided weakness and slurred speech. He was treated for stroke with a clot buster. He had imaging of his brain. But no lesion was seen. Because no lesion was seen, his neurologist was dismissive.

He got the label of functional neurologic disorder (FND). He entered rehab. But without a real understanding of the mechanism of action underlying FND, appropriate care could not be started.

Then RCM Health was retained to organize appropriate care for Bill including providing access to the three modalities listed above: neurofeedback, psychedelic medications and

rTMS.

Bill also had a significant critical illness insurance policy that would pay out about CDN$200,000 with evidence of stroke. In this instance, Bill would get nothing because his stroke like syndrome did not show MRI or CT evidence of a brain lesion. Even though he had the same degree of disability as a patient with imaging evidence of stroke.

The Advanced Approach To Treating FND:

Modern FND treatment should but rarely does involve a comprehensive, integrated approach. Practitioners who understand FND can create personalized treatment plans that combine these novel therapies with traditional approaches, ensuring regular progress monitoring and strong patient education components. This holistic strategy recognizes that each patient's experience with FND is unique and requires an individually tailored treatment approach

For more information about FND treatment options or participation in clinical trials, contact RCM Health Consultancy at +1-647-350-5500 or visit www.rcmhealth.ca

Our team is committed to helping patients access the most current and effective treatments available.

To learn more about RCM services:

647-350-5500

info@rcmhealth.ca

Raymond Rupert  

CEO  

RCM Health Consultancy Inc.

www.rcmhealth.ca 

https://rcmhealthcare.ca