Legal teams and case managers supporting clients with Functional Neurological Disorders (FND) should be aware of the many ways the complex range of symptoms can adversely affect the quality of a person’s life, and the expertise a skilled medico-legal expert can bring to a case.  

Functional Neurological Disorder (FND), also known as Conversion Disorder, is a condition that affects the functioning of the nervous system, resulting in a variety of symptoms that cannot be fully explained by underlying organic or structural abnormalities

What is Functional Neurological Disorder?

FND, which can be triggered by brain/head injury and often occurs alongside psychiatric diagnoses including PTSD, is considered a type of somatic symptom disorder, where symptoms manifest as physical or sensory problems, but without a clear organic cause.

FND can present with a wide range of symptoms that may affect movement, sensation, vision, speech, or coordination. These symptoms may resemble those of other neurological conditions such as paralysis, tremors, seizures, difficulty speaking, chronic fatigue, or vision changes. However, unlike neurological disorders, functional neurological disorders do not have identifiable structural or physiological abnormalities in the nervous system as the underlying cause.

The exact cause of FND is not fully understood, but it is believed to involve a complex interaction between psychological, social, and neurological factors. Psychological factors, such as stress, trauma, or unresolved emotional conflicts are thought to play a role in triggering or exacerbating FND symptoms. Some research suggests that FND may involve disruptions in the brain’s processing of sensory and motor signals, leading to functional deficits.

Meet our FND expert witnesses

Find experts in the assessment of Functional Neurological Disorders and complex neurodisabilities by searching our database. 

About FND expert witnesses 

What kinds of legal cases may require an expert in functional neurological disorders?
Medical Negligence and Clinical Negligence Cases

If a provider is alleged to have misdiagnosed or improperly treated FND, resulting in harm or injury to the patient, a medical expert in FND may be needed to provide testimony on the standard of care, diagnostic criteria, appropriate treatment modalities, and potential complications associated with FND.

Rehabilitation, Care Planning, and Cost Projections

FND may result in functional limitations that affect an individual’s ability to work or perform daily activities. A medical expert in FND may be needed to assess the individual’s functional abilities, limitations, and the impact of FND on their ability to work or engage in other activities.

An expert may provide testimony on the types of rehabilitation interventions that are typically recommended for individuals with FND, the expected outcomes, and opinions on the estimated costs of FND-related treatments, therapies, medications, and other necessary interventions based on the individual’s specific condition and anticipated care needs.

How to select a medical expert witness for functional neurological disorder cases?

Selecting a medical expert witness for FND cases is a crucial step in building a strong legal case. A medical expert witness can provide valuable insights and opinions based on their expertise and experience, which can help support the legal arguments and increase the chances of a successful outcome in FND cases.

 Look for a medical expert who has specific expertise and experience in diagnosing, managing, and treating FND. The expert should be knowledgeable about the current understanding of FND, including its clinical presentation, diagnostic criteria, and evidence-based treatment approaches.

What kind of treatment and neurorehabilitation is possible for people with FND?

FND is a complex and individualised condition, and treatment plans may vary depending on the specific needs and circumstances of each patient. The goal of treatment is to improve functioning, reduce disability, and address any underlying psychological or emotional factors that may be contributing to the condition.

The treatment and neurorehabilitation approach typically involve a multidisciplinary approach that addresses the physical, psychological, and social aspects of the condition. It’s important to note that the specific treatment plan may vary depending on the individual’s symptoms, needs, and circumstances, and should be tailored to their unique situation.

Following a neuropsychological assessment, psychotherapy, such as cognitive-behavioural therapy (CBT), may be used to address any underlying psychological or emotional factors that may be contributing to neurological symptoms. This may include addressing stress, anxiety, depression, or unresolved emotional conflicts that could be triggering or exacerbating FND symptoms.

Physiotherapy may be used to address any physical deficits or functional limitations associated with FND symptoms. This may include exercises to improve strength, coordination, mobility, and balance. Physiotherapists may also use techniques such as desensitisation or graded exposure to help individuals gradually reintegrate into physical activities they may have been avoiding due to their symptoms.

Occupational therapy may focus on improving an individual’s ability to perform daily activities and tasks, such as self-care, work, and leisure activities. Occupational therapists may use techniques such as energy conservation, environmental modifications, and adaptive equipment to help individuals with FND optimise their independence and participation in meaningful activities.

Speech therapy may be considered if an individual with FND is experiencing speech or swallowing difficulties. Speech-language pathologists may use techniques to improve speech production, language skills, voice control, or swallowing function, depending on the specific symptoms and needs of the individual.

In some cases, medications may be used to manage associated symptoms of FND, such as anxiety, depression, or chronic pain. The specific medications and dosages used will depend on the individual’s symptoms and medical history, and should be carefully monitored by a qualified healthcare professional.

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NRC Medical Experts believe that individuals living with the debilitating complications of FND and functional conditions should be offered neurorehabilitation to reduce the impact on their quality of life.

Appoint an expert in the assessment of Functional Neurological Disorder with co-occurring brain injury. Find a Consultant in Rehabilitation Medicine, a consultant neurologist, a clinical neuropsychologist, a consultant psychiatrist, a consultant neuropsychiatrist and more by searching our expert witness directory.

Supporting personal injury claims, clinical negligence claims and medical malpractice cases, NRC Medical Experts assesses, evaluates and produces high-quality court expert reports and medical expert witness testimony to support legal teams representing clients with neurological disorders, traumatic brain injury, spinal cord injury, and other catastrophic injuries.