TY - JOUR
T1 - The role of evidence-based guidelines in the diagnosis and treatment of functional neurological disorder
AU - Tolchin, Benjamin
AU - Baslet, Gaston
AU - Carson, Alan
AU - Dworetzky, Barbara
AU - Goldstein, Laura
AU - LaFrance Jnr, W. Curt
AU - Martino, Steve
AU - Perez, David
AU - Reuber, Markus
AU - Stone, Jon
AU - Szaflarski, Jerzy
N1 - Funding Information:
Jerzy P. Szaflarski – In the last 24 months, Dr. Szaflarski received funding from the National Institutes of Health, National Science Foundation, Shor Foundation for Epilepsy Research, Department of Defense, UCB Pharma Inc., NeuroPace Inc., Greenwich Biosciences Inc., Biogen Inc., Xenon Pharmaceuticals, Serina Therapeutics Inc., and Eisai, Inc.; has served on consulting and advisory boards for Greenwich Biosciences Inc., NeuroPace, Inc., Medical Association of the State of AL, Serina Therapeutics Inc., LivaNova Inc., UCB Pharma Inc., Lundbeck, SK LifeSciences, Alabama State Medical Cannabis Study Commission, National Coordinating Center for Epilepsy under the Health Resources and Services Administration (HRSA)/Maternal and Child Health Bureau (MCHB), and Elite Medical Experts LLC; and on editorial boards for Epilepsy & Behavior, Journal of Epileptology (associate editor), Epilepsy & Behavior Reports (associate editor), Journal of Medical Science, Epilepsy Currents (contributing editor), and Folia Medica Copernicana.
Funding Information:
Benjamin Tolchin has received research funding from a US Veteran Administration (VA)’s VISN1 Career Development Award, the VA Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center of Innovation, and the C.G. Swebilius Trust. He has received honoraria from Columbia University Medical Center, the International League against Epilepsy, and the American Academy of Neurology.
Funding Information:
Barbara A. Dworetzky is on the board of directors of the American Epilepsy Society and the professional advisory board for the Epilepsy Foundation of New England. She receives salary support from the A. J. Trustey Research Fund, royalties from Oxford University Press, consultant fees from Bioserenity and Best Doctors. She is on the editorial board of nonepilepticseizures.com and has received honoraria for continuing medical education lectures on FND from Oakstone publishing.
Funding Information:
Jon Stone receives royalties from UpToDate for articles on FND and has received honoraria for continuing medical education lectures on FND. He runs a free self-help website for people with FND at neurosymptoms.org. JS carries out independent expert medicolegal work including in relation to FND. JS is secretary of the FND society and on the medical advisory board for FND Hope and FND Action. He has received funding from Scottish Government and the National Institute of Health Research.
Funding Information:
W. Curt LaFrance, Jr. has served on the editorial boards of Epilepsia, Epilepsy & Behavior; Journal of Neurology, Neurosurgery and Psychiatry, and Journal of Neuropsychiatry and Clinical Neurosciences; receives editor’s royalties from the publication of Gates and Rowan’s Nonepileptic Seizures, 3rd ed. (Cambridge University Press, 2010) and 4th ed. (2018); author’s royalties for Taking Control of Your Seizures: Workbook and Therapist Guide (Oxford University Press, 2015); has received research support from the Department of Defense (DoD W81XWH-17–0169), NIH (NINDS 5K23NS45902 [PI]), Providence VAMC, Center for Neurorestoration and Neurotechnology, Rhode Island Hospital, the American Epilepsy Society (AES), the Epilepsy Foundation (EF), Brown University and the Siravo Foundation; serves on the Epilepsy Foundation New England Professional Advisory Board, the Functional Neurological Disorder Society Board of Directors, the American Neuropsychiatric Association Advisory Council; has received honoraria for the AES Annual Meeting; has served as a clinic development consultant at University of Colorado Denver, Cleveland Clinic, Spectrum Health, Emory University, Oregon Health Sciences University and Vanderbilt University; and has provided medico- legal expert testimony.
Funding Information:
Laura H. Goldstein receives is a Director of the FND Society and a member of the Medical Advisory Board for FND Action. She receives royalties from Wiley and from Taylor & Francis and salary support from the National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at the South London and Maudsley NHS Foundation Trust and King’s College London. The views expressed in this publication are those of the author and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2021
PY - 2021/11/23
Y1 - 2021/11/23
N2 - Evidence-based clinical practice guidelines, based on systematic reviews of existing evidence, play an important role in improving and standardizing the quality of patient care in many medical and psychiatric disorders, and could play an important role in the diagnosis and treatment of functional seizures and other functional neurological disorder (FND) subtypes. There are several reasons to think that evidence-based guidelines might be especially beneficial for the management of FND. In particular, the interdisciplinary and multidisciplinary teamwork necessary for the care of people with FND, the current lack of formal clinical training in FND, and the rapidly expanding body of evidence relating to FND all make guidelines based on systematic literature reviews especially valuable. In this perspective piece, we review clinical practice guidelines, their advantages and limitations, the reasons why evidence-based guidelines might be especially beneficial in the diagnosis and treatment of FND, and the steps that must be taken to create such guidelines for FND. We propose that professional organizations such as the American Academy of Neurology and the American Psychiatric Association undertake guideline development, ideally to create a co-authored or jointly endorsed set of guidelines that can set standards for interdisciplinary care for neurologists and mental health clinicians alike.
AB - Evidence-based clinical practice guidelines, based on systematic reviews of existing evidence, play an important role in improving and standardizing the quality of patient care in many medical and psychiatric disorders, and could play an important role in the diagnosis and treatment of functional seizures and other functional neurological disorder (FND) subtypes. There are several reasons to think that evidence-based guidelines might be especially beneficial for the management of FND. In particular, the interdisciplinary and multidisciplinary teamwork necessary for the care of people with FND, the current lack of formal clinical training in FND, and the rapidly expanding body of evidence relating to FND all make guidelines based on systematic literature reviews especially valuable. In this perspective piece, we review clinical practice guidelines, their advantages and limitations, the reasons why evidence-based guidelines might be especially beneficial in the diagnosis and treatment of FND, and the steps that must be taken to create such guidelines for FND. We propose that professional organizations such as the American Academy of Neurology and the American Psychiatric Association undertake guideline development, ideally to create a co-authored or jointly endorsed set of guidelines that can set standards for interdisciplinary care for neurologists and mental health clinicians alike.
UR - http://www.scopus.com/inward/record.url?scp=85119625395&partnerID=8YFLogxK
U2 - 10.1016/j.ebr.2021.100494
DO - 10.1016/j.ebr.2021.100494
M3 - Article
VL - 16
JO - Epilepsy & Behavior Reports
JF - Epilepsy & Behavior Reports
M1 - 100494
ER -