One of the ironic features of this sad state of affairs is that if a doctor showed a similar degree of inability to reflect or respond to criticism it would be viewed as a problem behaviour at appraisal
Today we have responded to the BMA, strongly rejecting the basis on which they have proposed to bring legal proceedings.
You can read our statement on our website -
The Cass review was thoughtful and considered- it acknowledges the grey areas and most notably doesnt say half the things attributed to it. For the BMA to disavow it would be a serious lapse in judgement- energy far better spent campaigning for better care for trans kids
NEW: The governing body of the doctors’ union - the BMA - will vote tomorrow on a motion to ‘disavow’ the Cass Review into the care provided to gender-questioning children and young people. Exclusive by me for the
@NewStatesman
Mortality in patients with psychogenic nonepileptic seizures | Neurology. Important paper. PNES same mortality rate as drug resistant epilepsy- we found hints of this in our SNSS study. Lets start taking this as seriously as it deserves
Functional cognitive disorders: a systematic review - The Lancet Psychiatry.
@lauramcw
made a fantastic effort on this paper; I hope it has the impact it merits. We think this is important for anyone working in fields of dementia or brain injury.
@SkyNewsBreak
@AlbertoCostaMP
well done for acting with decency and trying to protect rights of brits in europe and europeans who have done us the honour of choosing to live here. Seems
@Anna_Soubry
was on the money with her comments on
@theresa_may
and immigration
First day of walking through front door of our new neuroscience hospital- there have been some well publicised teething problems- but the end result is pretty bangin’
Psychiatric sequelae of traumatic brain injury — future directions in research | Nature Reviews Neurology. Pleased to see this out- the wonderful
@NeuroDocLucia
did the heavy lifting
Mark Edwards nails not just FND but also a large part of medical practice in one slide. The whole talk is available at the
@FNDSociety
website but i m afraid you have to join if you missed it live- but then you should join anyway
@krishgm
Why would you be shocked by managerial response- its been identical in every major NHS scandal- unless we can change culture to get senior managers to welcome hearing ‘bad things’ we wont improve
The British guideline for CFS/ME is the result of activism, not research. Patient experience is important but we need to remember there is no such thing as a typical patient and be aware of excluded voices
@NICEComms
The notion of an essay on Functional Neurological Disorders winning a
@Brain1878
essay prize was unimaginable when i started in a then obscure field of research 28 years ago- we ve come a long way- congratulations to
@popkirov
but also
@MasudHusain
for editorial leadership
“Scan-negative” cauda equina syndrome: A prospective cohort study | Neurology.
@IngridHoeritza1
phd study out today. There are a lot of take home messages on CES. PR a waste of time but do check those ankle jerks- much more inside.
@dr_shibley
Agreed but if changed name back to physician assistant many of these problems would be solved overnight- it’s instantly clear the role whereas associate drliberately obfuscates
@DinahGLRoseKC
If your prediction holds true, and given your expertise, i assume it will- it will be a very bad day for parliament and indeed the law. The electorate cares about this issue and we ve all seen the photos.
@jimwaterson
@StopFundingHate
This is a form of gaslighting - noone from BLM is suggesting Churchill’s statue should come down and to start a campaign like this leads directly to the scenes we saw yesterday - its highly irresponsible
@JeremyVineOn5
@alex_polizzi_
@theJeremyVine
I m roughly the same age and 30 years ago groping someone’s thigh under the table at a business meeting was ( correctly) regarded as a sackable offence/ and socially would get a well earned slap. What arrent nonsense to normalise this
The phd we re offering in functional cognitive disorders is a fantastic opportunity- as are the other phds in the programme- all include time in a second participating centre and with a private industry partner
@sjblakemore
I think we are getting this very wrong. Should be setting up dedicated out door social venues where students can mingle. But discourage from general community venues.And offering dedicated testing facilities. risks from loneliness may outweigh corona risks for this population
The neurology of the Cuban “sonic attacks” - The Lancet Neurology. Really pleased with this paper- i like to think it has some helpful insights about cuban ‘attacks’ but more importantly about functional disorders in general
On International Women in Science Day i d like to highlight m two fabulous colleagues
@lauramcw
and
@IngridHoeritza1
who combine being sensational clinician scientists with the best craic
It’s my wonderful daughter’s 18th birthday today- she was supposed to be celebrating with her friends on the beautiful island of Hvar but, like so many plans, it had to go & instead she is stuck with me. The company may be dull for her but at least the wine will be better quality
@emahase_
@bmj_latest
@TheDA_UK
@CNagpaul
Correct decision but this should have been made when case first arose. I hope there will now be a proper investigation of actions of clinical management team who pushed this claim forwards
Next Thursday’s
@FNDSociety
webinar will be by Joe Jankovic speaking on dystonia- organic v functional. Joe is an absolute guru of dystonia so should be good. Free - Sign up at (pictured here at Ed FND conf-in happier times!)
@kailashbhatia
@wendyburn
I don’t wish to comment on the individual concerned but isn’t displacement exactly the point. Medical staff feeing chronically undervalued and not respected.
Mark Edwards discusses what functional neurological disorders reveal about modern medicine, and argues that the passivity of the traditional sick role needs replacing with a participatory, rehabilitative medical practice.
After years of literay theorists and historians doing feminists citiques of hysteria, that were clinically illiterate, here’s one from people who ve actually done the hard yards on the shop floor- I think this will become a classic
Functional Cognitive Disorder: Diagnosis, Treatment, and Differentiation from Secondary Causes of Cognitive Difficulties - ScienceDirect. Particularly relevant for those working with early onset dementia, mTBI/ concussion and long covid
This Thursday’s
@FNDSociety
webinar will be by Tim Nicholson on the complex relationship between FND and traumatic events. Many years, ago I examined Tim’s phd on this topic. Trust me, no one better to give this talk. Visit society website for details
At least 69 suicides linked to DWP's handling of benefit claims - extrapolating from the distress i see in every clinic i would be surprised if the number was as low- the stories of the process are gut wrenching
Functional neurological disorder after vaccination: a balanced approach informed by history | Royal College of Physicians of Edinburgh- as ever there is nothing new- we just fail to learn the lessons
@UKGastroDr
They all get private healthcare as part of their GMC renumeration package. Something that should be stopped instantly- i object strongly to paying for it- they should have to rely on nhs- would focus their minds
@gmcuk
This was very poor- if we set up long covid as either physiological ie real versus mental not real we will fail patients. This distinction is neuroscientifically illiterate. All mental disorders have a physiology and are real. In detailed phenotyping studies we find a lot of FND
So we know that it’s rare that FND diagnoses turn out to be wrong. What about the other way round- how often do other neurological disorders turn out to have been misdiagnosed FND all along?
My delightful wife’s birthday- 33 years together and counting. How to celebrate? Kids had answer a Smiths tribute band, we even took a double decker bus home
@trishgreenhalgh
Maybe the problem is your use of dismissed which implies one form of aetiology as more worthy than another- as far as neurological symptoms go there is mounting clinical and scientific evidence of a functional cause but this doesn’t mean the patient is any less sick or deserving
@nataliesurely
What troubles me about this whole conversation is that so many people take the explicit starting point that if long covid does ultimately prove to be functional that it is in some wsy a less worrhy condition
So just of phone from international conference call- its done, an international society: the Functional Neurological Disorders Society is go. Due for legal incorporation in next couple of weeks. More news to follow...
This Thursday’s
@fndsociety
webinar is on physiotherapy by the wonderful
@GNielsen_Physio
(middle) . & with discussion from
@kailashbhatia
all chaired by
@valvoon
if you haven’t heard Glenn speak before you will have your eyes opened.
Next Thursday’s
@FNDSociety
webinar will be by Stoyan Popkirov on Emergency presentations of FND- this is a reall problem area so tune in 11EST free to access live but must register at
Occupational therapy consensus recommendations for functional neurological disorder | Journal of Neurology, Neurosurgery & Psychiatry. Clare Nicholson who led this project will be presenting it as the
@FNDSociety
webinar on Thurs 6th Aug- tune in
Expanding the therapeutic toolkit in functional neurological disorder: consensus recommendations for speech and language therapy | Journal of Neurology, Neurosurgery & Psychiatry
Plans to shorten medical training It is easy to think of medicine as countable procedures - cataracts endoscopy etc but most of it is complex decision making in multi morbidity and differentials- shortening training will likely backfire in litigation costs
This is an interesting area. Had 7 or 8 cases with functional parkinsonism for up to a decade before PD emerged. Also cases of functional motor symptoms preceding FTD by around 1 year. Presumably very early subtle motor sequencing difficulties form nidus for FND in the vulnerable
A new potentially malignant subtype of Parkinson presented by
@AlbertoEspay
If functional symptoms before PD diagnosis this may be a 'red flag.' Keep your eyes on how this story plays out.
@movedisorder
Stigma in functional neurological disorder (FND) – A systematic review - ScienceDirect Our review of Stigma in FND - the excellent Caoimhe McLoughlin did all the heavy lifting
Webinar Registration - Zoom the first of our new FND education programme goes live Thursday 14th May. Free access but must register in advance. First talk Dr Mark Hallett on an introduction to FND. Mark is Chief of Human Motor Control NINDS- it’s a goodie
Neuroimaging in Functional Neurological Disorder: State of the Field and Research Agenda - ScienceDirect. Well led by
@PerezMGHLab
sema aybek and
@Tim_R_Nicholson
If anyone doubts what stigma looks like just read what the typical medic / academic suffering LC has to say when it is even suggested that some long covid symptoms may be functional - then think wonder what sort of attitudes patients with FND face
@nataliesurely
What troubles me about this whole conversation is that so many people take the explicit starting point that if long covid does ultimately prove to be functional that it is in some wsy a less worrhy condition
Hiding in Plain Sight: Functional Neurological Disorders in the News | The Journal of Neuropsychiatry and Clinical Neurosciences. Interesting observations on recent news stories and how often supposedly ‘rare’ diseases prove to be functional
Disrespectful language about patients with long COVID - The Lancet. Says it all really- there should be no doubting the deep layers of prejudice that underpin some of the language, assumptions and discussion around long covid
There is a real need for greater awareness and understanding of functional cognitive disorders- anyone seeing patients with dementia needs to be competent - ABN have defined as core skill for neurologists/ psychiatry paradoxically have been more reluctant to get up to speed
@GoStargazing
@treesey
Remarkable- goes beyond vandalism and must have required significant equipment and knowledge- but why on earth would you do that- who hates a tree in middle of nowhere
@TheLancetPsych
@joannamoncrieff
Well well well antipsychotic maintance had no negative impact on social function but significantly reduced relapse rate
Hey so, normally I don’t share detailed health information here, but something’s happened recently and I thought I should describe it in case it’s helpful for anyone else w FND.
Interesting trial- once again showing rehabilitative exercise is beneficial in fatigue states- there comes a point where
@NICEComms
is going to have to recognise the harm their anti- scientific guidance is doing
A randomized trial for
#LongCovid
in 589 participants showing quality of life benefit for an 8-week, individualized, online, home-based, supervised group physical and mental rehab program (REGAIN) compared with usual care at 3 and 12 months
@Gord_McG
Next Thursday (14 th Jan - 11h EDT/ 16h GMT) FND society webinar will be Christos Ganos speaking on functional tics and repetitive movement disorders. We re expecting a thought provoking presentation so join us- free to view to register
Performance validity test failure in clinical populations—a systematic review | Journal of Neurology, Neurosurgery & Psychiatry. Do ‘effort’ tests really work- not in terms of informing diagnosis. High failure rates in patients with dementia and severe TBI
Yesterday more reasons for psychiatry and neurology to work together- Psychological precursors of epileptic seizures - Michaelis - Epilepsia - Wiley Online Library
@wendyburn
@dr_dr_uk
@trentconsultant
@rcpsych
If that happened would be very helpful but one of the issues is that people get bored doing the routine health management and want more interesting roles so they negotiate them as a permanent presence- all too easy for task to fall back on the rotating trainees
Wellbeing classes do not improve workers’ mental health, research suggests. No surprise- basics - respect, paying staff rather than 3 months chasing, doing rotas well, avoiding meaningless paper work=a difference
Functional Neurological Disorder Society will hold it inaugral meeting in Boston on 14-16 June 2020. It follows from international meeting held in Edinburgh generously supported by
@movedisorder
@NINDSdirector
@CathCalderwood1
. We’re delighted with BU venue+ cheap accommodation
Podcasts | FNDS. We re only a week away from inaugural scientific meeting of FND Society- its still possible to register for online- if you’re swithering have a listen to these podcasts to get you in mood and check out the program- i m biased but its fab!
Everytime you hear someone complain of young people as snowflakes or selfish just remember they uncomplainingly sacrificed there own happiness to keep their grandparents alive from a virus they were at very low risk from
“Teenage boys were hit hardest by the Covid lockdowns, with their mental health failing to recover despite the return to normality, according to the most comprehensive academic study of its kind.”
This Thursday’s
@FNDSociety
webinar will be a multi disciplinary presentation from Chicago group led by
@LaFaverMD
on telemedicine services for FND
Heading in the right direction | Nature Reviews Neurology.
@WillStewNeuro
and I comment on the
@FootballAssoc
decision to ban heading for under 12s we are supportive of the move but advocate a global brain health approach for footballers
Not only does early intensive rehab improve outcomes but it saves money down the line in care costs- programmes pay for themselves- the more intense you go the more money you get back
People with moderate to severe brain injury may be left with a range of disabilities, including difficulties with mobility, employment, education and social interaction. A study has found early, intense rehabilitation helps recovery
Founding Members | FNDS. The list of founding members of the Functional Neurological Disorders Society grows steadily; an impressive multi- disciplinary array of talent. Interested in FND, do join us