Psych CASC / OSCE · General adult psychiatry
Explaining functional neurological disorder to a patient — CASC communication station
MRCPsych/FRANZCP-style station: non-pejorative FND explanation, positive-sign rationale, MDT treatment hope, and check understanding.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 32-year-old woman with sudden leg weakness and Hoover's-positive examination has been told by a friend that conversion disorder means she is 'putting it on'. She wants plain-language explanation of FND, how you know, whether she is crazy, what treatment involves (physio and psychology), and whether she will walk again.
Station brief
Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry (or neuropsychiatry) registrar. The patient is in clinic after neurology review. [1]
Candidate instructions. Explain functional neurological disorder in plain language; address the fear of “putting it on”; outline how positive signs support the diagnosis; describe specialist physiotherapy and psychological support; give realistic hope without false certainty; check understanding and invite questions. Avoid jargon dumps and pejorative terms. [1][2]
References4ShowHide
- [1]Stone J, Burton C, Carson A Recognising and explaining functional neurological disorder BMJ, 2020.PMID 33087335
- [2]Aybek S, Perez DL Diagnosis and management of functional neurological disorder BMJ, 2022.PMID 35074803
- [3]Nielsen G, Stone J, Matthews A, et al. Physiotherapy for functional motor disorders: a consensus recommendation J Neurol Neurosurg Psychiatry, 2015.PMID 25433033
- [4]Espay AJ, Aybek S, Carson A, et al. Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders JAMA Neurol, 2018.PMID 29868890