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Final Program


Final Program

1302 - A Functional Neurologic Dilemma: A Case Series on the Rehabilitation of Functional Neurologic Disorder with Concomitant Brain Injury

Friday, February 28, 2025
5:00 PM - 6:30 PM MST

    Presenting Author(s)

  • KN

    Katrina U. Ngo, DO

    Resident Physician
    University of Washington
    Seattle, Washington, United States

    • Co-Author(s)

  • MW

    Madeline Weismann, PT

    Physical Therapist
    Harborview Medical Center
    Seattle, Washington, United States

  • CJ

    Cherry Junn, MD

    Assistant Professor
    University of Washington
    Seattle, Washington, United States

Case Diagnosis: Functional neurological disorder (FND), formerly known as conversion disorder, is defined as one or more symptoms that affect body movement or senses that cannot be explained by a neurological condition or other mental health disorder. Psychogenic non-epileptic seizures (PNES) is a type of FND that presents with attacks that look like epileptic seizures but are triggered by psychological or emotional distress.  

Case Description:

This case series aims to describe the strategies used and challenges faced in the rehabilitation of gait abnormalities in patients with FND and concomitant brain injuries.  Three patients’ rehabilitation courses will be described: a 19 year-old male who sustained a moderate traumatic brain injury resulting in waxing and waning  gait abnormalities attributed to FND, a 42 year-old female who  was found to have a small left frontal acute infarct resulting in mobility deficits out of proportion to her stroke as well as PNES, and a 60 year-old female with cerebellar ataxia secondary to paraneoplastic syndrome with concomitant PNES. 

Discussions: Inpatient rehab for patients with FND, focuses on the patient’s gait abnormalities through a Return to Walk Program (RWP). RWP includes a step-wise protocol involving graded exercises and strict requirements for progression and typically involves an interdisciplinary team that includes PM&R, rehabilitation psychology, physical therapy, and occupational therapy. When a patient has a comorbid brain injury, it may be necessary  to expand the team to include speech therapy as well as rehabilitation nursing.

Conclusions:

General principles of FND rehabilitation can be applied to patients who have a diagnosis of FND in addition to a brain injury diagnosis, although a strict RWP may not be beneficial. There should be flexibility built into the program to adjust based on clinical judgment.