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Multidisciplinary clinic for functional movement disorders (FMD): 1-year experience from a single centre
  1. Alexandra E Jacob1,
  2. Courtney A Smith2,
  3. Megan E Jablonski2,
  4. Abbey R Roach2,
  5. Kathy M Paper3,
  6. Darryl L Kaelin4,
  7. Diane Stretz-Thurmond3,
  8. Kathrin LaFaver1
  1. 1Department of Neurology, University of Louisville, Louisville, Kentucky, USA
  2. 2Division of Psychology and Neuropsychology, Frazier Rehab Institute, Louisville, Kentucky, USA
  3. 3Frazier Rehab Institute, Louisville, Kentucky, USA
  4. 4Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky, USA
  1. Correspondence to Kathrin LaFaver, Department of Neurology, University of Louisville, Louisville, KY 40202, USA; kathrin.lafaver{at}louisville.edu

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Introduction

Although labelled a ‘crisis for neurology’ in 2006, little progress has been made towards improved management of patients with functional movement disorders (FMD). FMD is commonly seen in neurological practice, yet the best approach to treatment is ill defined. Prognosis is often poor, and most patients fail to improve without treatment, especially those with symptoms lasting beyond 1 year.1 Collaboration between neurologists and mental health providers is suggested to optimise care for patients with FMD, yet communication between different specialists is often lacking in practice.1–3 Physical therapy and multidisciplinary treatment programmes have shown benefits but are not widely available to patients.4 5 Multidisciplinary clinics have  been shown to improve care for patients with complex neurological disorders such as Huntington’s disease and amyotrophic lateral sclerosis and we believe a similar approach should be considered for FMD. We have developed a multidisciplinary clinic to provide comprehensive evaluation and treatment planning for patients with FMD. Here, we report our experience from the first year of the clinic.

Methods

Our FMD clinic takes place at Frazier Rehab Institute in Louisville, Kentucky, USA, and is composed of a movement disorder specialist, psychologists, physical therapists and a social worker. The clinic is held once a month for a half-day and accommodates three patients. Patients …

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