Functional neurological disorder in Europe: regional differences in education and health policy

Tereza Serranová, Ilaria Di Vico, Michele Tinazzi, Selma Aybek, Ervina Bilic, Stefanie Binzer, Erlend Bøen, Arnout Bruggeman, Christo Bratanov, Veronica Raquel Alheia Cabreira, Dawn Golder, Anna Dunalska, Cristian Falup-Pecurariu, Beatrice Garcin, Jeannette Gelauff, Aoife Laffan, Simon Podnar, Isabel Pareés, Tom Plender, Stoyan PopkirovVolodymyr Romanenko, Petra Schwingenschuh, Yury Seliverstov, Carl Sjöström, Matej Škorvánek, Maria Stamelou, Donatas Zailskas, Mark J. Edwards, Jon Stone*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

Background: Functional neurological disorder (FND) is a common cause of neurological disability. Despite recent advances in pathophysiological understanding and treatments, application of this knowledge to clinical practice is variable and limited. Objective: Our aim was to provide an expert overview of the state of affairs of FND practice across Europe, focusing on education and training, access to specialized care, reimbursement and disability policies, and academic and patient-led representation of people with FND. Methods: We conducted a survey across Europe, featuring one expert per country. We asked experts to compare training and services for people with FND to those provided to people with multiple sclerosis (MS). Results: Responses from 25 countries revealed that only five included FND as a mandatory part of neurological training, while teaching about MS was uniformly included. FND was part of final neurology examinations in 3/17 countries, unlike MS that was included in all 17. Seventeen countries reported neurologists with an interest in FND but the estimated mean ratio of FND-interested neurologists to MS neurologists was 1:20. FND coding varied, with psychiatric coding for FND impacting treatment access and disability benefits in the majority of countries. Twenty countries reported services refusing to see FND patients. Eight countries reported an FND special interest group or network; 11 reported patient-led organizations. Conclusions: FND is largely a marginal topic within European neurology training and there is limited access to specialized care and disability benefits for people with FND across Europe. We discuss how this issue can be addressed at an academic, healthcare and patient organization level.

Original languageEnglish
Article numbere16350
JournalEuropean Journal of Neurology
Volume31
Issue number10
Number of pages10
ISSN1351-5101
DOIs
Publication statusPublished - Oct 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Keywords

  • disability benefits
  • education curricula
  • functional neurological disorder
  • healthcare
  • patient-led organization
  • Multiple Sclerosis/therapy
  • Neurology/education
  • Humans
  • Europe
  • Nervous System Diseases/therapy
  • Health Services Accessibility
  • Health Policy
  • Neurologists

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