Psych CASC / OSCE · Consultation-liaison psychiatry
Ward explanation of FND and team alignment — CASC / C-L station
MRCPsych/FRANZCP-style C-L communication station: non-pejorative FND explanation after a botched 'all stress' message, MDT plan, and discharge safety-net.
On this page
Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 38-year-old man on a medical ward has functional left leg weakness after a minor fall. Hoover's sign is positive. A junior doctor told him 'your scans are fine so it must be stress'. He feels dismissed and asks if psychiatry thinks he is faking. You must explain FND, repair the message, outline ward and outpatient care (physio and psychology), and agree safety-nets before discharge planning.
Station brief
Format. Communication station, approximately 7–10 minutes. You are the C-L psychiatry registrar on the medical ward. Neurology has documented positive Hoover's sign. [1][5]
Candidate instructions. Repair the dismissive “only stress / normal scan” message; explain FND in plain language; affirm that symptoms are real and not feigned; link positive signs; outline specialist physiotherapy and psychological support; safety-net red flags; check understanding and next steps. Avoid jargon dumps and pejorative terms. [1][2]
References5ShowHide
- [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
- [5]Bennett K, Diamond C, Hoeritzauer I, et al. A practical review of functional neurological disorder (FND) for the general physician Clin Med (Lond), 2021.PMID 33479065