Discover and read the best of Twitter Threads about #fnd

Most recents (24)

Participated in a very interesting multidisciplinary POTS conference at @HopkinsMedicine on the topic of #FND, #syncope and #POTS where we discussed and debated the numerous issues surrounding FND diagnosis in our patient population. 1/🧵
#MedTwitter #NeuroTwitter
@HopkinsMedicine After conference, saw a patient who highlighted the issues discussed at conference.
👩‍🦽30 yo woman with POTS/MCAS/EDS triad with one TTT positive for POTS, but a 2nd TTT negative
❌ A neurologist diagnosed her with FND
💉 She is on allergy shots & many H1/H2 blockers.
@HopkinsMedicine 🚫 Neurologist didn't take into consideration neurologic and psychiatric manifestations of SYSTEMIC DISEASE (MCAS)
❌ This is not FND because there is underlying systemic disorder driving symptoms and signs.
🧠 Patient needs to be treated for the SYSTEMIC DISORDER first.
Read 6 tweets
This is a highly relevant study from Japan on #Dysautonomia, #gAchR antibodies and #FND!

I'll explain why it's important and what it means in clinical terms. 1/🧵

#MedTwitter #NeuroTwitter @Dysautonomia…
@Dysautonomia What the study found:
✅ Out of 59 patients who qualified for #FND diagnosis by DSMV criteria, 88% had autonomic symptoms!!!
✅ 27% were positive for ganglionic acetylcholine receptor antibody (gAchR Ab) via LIPS assay.
✅ 50% had #POTS.
✅ 50% had orthostatic hypotension.
@Dysautonomia Why is this important?
✅ Our patients are often misdiagnosed with #FND, and this study proves that.
✅ When #FND is diagnosed, treatment is psychotherapy & physical therapy, which is not a treatment for #Dysautonomia.
✅ We MUST identify and treat #Dysautonomia symptoms.
Read 4 tweets
On April 5, 2022, I lost my words
It started with a feeling of numbness spreading down my left side, quickly growing prickly and painful. I felt very sleepy, like I was shifting out of consciousness.
The next day I felt some numbness and weakness in my face, and a growing headache. By that night, my speech was becoming slower, slurred.
Read 25 tweets
✨Sharing "Identification of bio psychological trait markers in functional neurological disorders"✨, published #OpenAccess in @Brain1878 with @LoukasSerafeim @SelmaAybek

Some of the highlights below 🧵. (1/16)…
Recent pathophysiological models in functional neurological disorders (#FND) focus on a multifactorial origin integrating predisposing, precipitating and preceding risk factors.

But what does that mean?
Can biopsychosocial vulnerability factors potentially explain the development of FND symptoms in a subgroup of (biologically) vulnerable individuals with certain psychosocial risk factors? (3/16).…
Read 16 tweets
I think often about the TRANSLATION GAP - the ways that state-of-the-art brain science does not enter clinical discourse, practice, & education. MAJOR MISCONCEPTUALIZATIONS of Functional Neurological Disorder by PHYSICIANS point this out. #FND Brain Science: "The Basics". 1/20
Theme 1: MOTOR INHIBITION BY PREFRONTAL BRAIN AREAS - In an early study, Marshall et al. showed that attempted movements of the leg w functional weakness did not activate primary motor areas but led to anterior cingulate & orbitofrontal activity
DOI: 10.1016/s0010-0277(97)00020-6
Theme 1a: Vuilleumier et al. showed that preparing to move the limb with functional weakness led to increased prefrontal activity (i.e. ventromedial prefrontal cortex), suggesting THE INSTRUSION of prefrontal areas into movement.

Read 20 tweets
There have been a series of comments on #Twitter (including by MDs) highlighting that Functional Neurological Disorder remains markedly misunderstood & dismissed by portions of the MEDICAL community. Part of the issue is a FALSELY dualistic framing of complex brain disorders. 1/6
In a @FNDHope talk from a few years ago, I shared my viewpoint on how we can bridge Neurologic & Psychiatric/Psychological perspectives in #FND. Link to the talk below. @FNDHopeUK @FNDHopeUSA

Having trained in #Neurology & #Psychiatry, many NeuroPsychiatric conditions (capital N capital P) benefit from an integrated clinical neuroscience perspective. Psychiatry can learn from Neurology, & Neurology can learn from Psychiatry @boeslab @keshavanms…
Read 6 tweets
1/Something that is rarely discussed in the medical literature around #FND is the mental health impact on a patient of being repeatedly told they have repressed psychological trauma when in fact they don't.
2/Having your experience of a disabling and very serious neurological illness negated and invalidated year after year, and being told by medical professionals you have trauma when you don't, can over time actually end up being very traumatising.
3/ There is a running joke among FND patients that if you didn't have PTSD at the beginning, by the time you have been through the medical system, you probably will do.
Read 18 tweets
🧵 Our guidebook provides information, support and signposting.

📕 Chapters for young people, parents & caregivers & schools.

🔬Evidence based information & case studies

🤗 Nobody has to feel alone.

To learn more ⬇️

#LongCovid #LongCovidKids ImageImageImageImage
Long Covid Kids started as a grassroots organisation in September 2020.

In October 2021 we became a registered charity.

Our patron is beloved children’s author @MichaelRosenYes

#LongCovidKids #LongCovid #MichaelRosen #Charity #Support #Children ImageImageImageImage
With the support of experts, scientists, paediatricians, doctors, nurses, researchers, advocates, occupational therapists, physiotherapists teachers & educational psychologists our team of volunteers created a guidebook to raise awareness & educate.

#LongCovidKids #LongCovid ImageImageImageImage
Read 26 tweets
Sharing “A New Science of Emotion: Implications for Functional Neurological Disorder”, just published in @Brain1878. Great collaboration with @SaraParedesEch1, @popkirov, @LFeldmanBarrett, @PerezMGHLab! Some highlights of the paper below 🧵. (1/15)…
What are emotions and what role do they play in the pathophysiology of Functional Neurological Disorder (#FND)? We have long debated this, but missed to ask ourselves: "What are emotions in the first place?" (2/15)
10 years ago, Edwards, Adams et al. started the conversation on a Bayesian account of Functional Neurological Disorder:…. Here, we sought to leverage the latest neuro-constructionist approaches to revisit the role of emotion in #FND. (3/15)
Read 15 tweets
💈On the day the @ons report 26,000 CYP have symptoms for at least a year (⬆️ 3000 from last mth)
we received an email from @10DowningStreet in response to our visit on April 1st
It confirms the concerns of the children⬇️

"We feel ignored"


April 1st - 12 #children living with #LongCovid traveled
to #london to deliver their own letters documenting their #pain, loss of #sight, #mobility, organ damage, diagnosis of #PANS #MECFS #FND #POTS #MCAS and the detrimental impact it has had on their lives.

100+ page guide providing evidence-based information on #LongCovid in CYP from industry experts, research, and statistics from @GOVUK @ONS.
Did anyone read it?
We were assured @BorisJohnson would receive it.

Read 13 tweets
FUNCTIONALITY GOALS OF 2019 vs. 2022 | Thank you to my donors from around the world who have helped me achieve one of the most difficult goals on my wish list in 2019: "ability to shade with a pencil again." We did it - despite COVID-19 lockdowns! #FND #goals #Health #support ImageImage
And no, I didn't use any rulers or tools. That's all freehand. I'm telling you - it's a freakin' miracle. I can't draw every day, but when I can - it brings back all these memories of when I had a body that worked. And it's important for it to remember. Thank you sooo much!!!
At the hotel, waiting for tomorrow. I made it, but #%%# it hurt!!! Trying to stay calm- I don't want an episode now! Lol! Here's the link to donate towards tomorrow's appointment!>>> Even a dollar makes a difference. It's up to you! LOVE!!!
Read 6 tweets
“ME/CFS: What Psychiatrists & Psychologists need to know” by @DoctorsWithME (March 2022)…

#MyalgicEncephalomyelitis #ChronicFatigueSyndrome #NeuroME #MEcfs #CFS #PwME #CFSME

#ME/#CFS is a chronic, complex, multi-system biological illness with often devastating consequences. It affects all age groups including children, and all social classes. About 75% of sufferers are female”

#MyalgicEncephalomyelitis #MEcfs #PwME #CFSME #ChronicFatigueSyndrome
ME/CFS “has a worse quality of life score than many other serious illnesses including cancer, stroke, rheumatoid arthritis and MS. 25% of patients are housebound or bedbound.”

#MyalgicEncephalomyelitis #ChronicFatigueSyndrome #MEcfs #CFS #PwME #MyalgicE #SevereME
Read 10 tweets
🧵: So this month is #FNDAwarenessMonth! And most people have never heard of #FND, so I thought I’d explain in an obnoxiously long thread how it’s affected me:
Functional Neurological Disorder is a very complex condition, but put simply it’s when the brain doesn’t send the right signals to the rest of your body. There’s no physical damage to the brain, but for whatever reason the signals aren’t sending correctly.
A good analogy for this is to think of FND as a software issue rather than a hardware issue, which we would use to describe a broken leg, for example.
Read 27 tweets
Trigger warning- Will try keep this short. Uncovering the scale of medical gaslighting and corporate corruption. Who teaches our doctors to dismiss medically unexplained symptoms as hysteria?

Lynn Turner- MUS management PowerPoint, Kings College London ImageImageImage
She also developed the GAS-light model as way of determining which treatments were worth trialling ie cost effectiveness - gauging effectiveness based on patient set goals for graded assessment. If we set the goals, its not on them if the treatments aren't effective, it's on us. ImageImage
Michael Sharpe is a psychiatrist&an author of the fraudulent #PACETrial. He does consulting work for insurance companies & advises them that #ME is a mental health disorder. Here he consulting for Swiss Re, classifying #LC as 'health anxiety'-
Read 14 tweets
During the 🧻 rush era of lockdown, while working at the brilliant #FND service @uclh, an #ophthalmologist 👁 (I happen to be married to) asked what services exist for all the patients with functional visual symptoms she saw?
Check out our paper:
We surveyed 119 ophthalmologists nationally and asked about their experience, understanding and management of functional visual symptoms (FVS). 2/7
Disclaimer - I hadn’t seen FVS, thought it was rare, but it seems so did the rest of psych & neuro. Small case series had been published.

All the while ophth 👁 has been seeing FVS regularly. An estimated 5%-12% of cases in the busiest outpatient specialty in the UK. 3/7
Read 7 tweets
1) More #longcovidkids are getting #FND diagnosis
What is Functional Neurological Disorder?
A problem with the functioning of the nervous system & how the brain & body sends / receives signals, rather than a structural disease process such as multiple sclerosis or stroke. FND
2) can encompass a wide variety of neurological symptoms
Motor dysfunction
• Functional limb weakness/paralysis
• Functional movement disorders; including tremor, spasms, jerky movements & problems walking
• Functional speech symptoms; including whispering speech, slurred or
3) stuttering speech
Sensory dysfunction
• Functional sensory disturbance inc altered sensation; e.g. numbness, tingling/ pain in the face, torso/ limbs. This often occurs on one side of the body
• Functional visual symptoms; inc loss of vision/ double vision #longcovidkids
Read 6 tweets
A metal ion orients SARS-CoV-2 mRNA to ensure accurate 2′-O methylation of its first nucleotide
The #SARSCoV2 #coronavirus is able to utilize the changes in metal ion concentrations to disguise itself in the human host body thus evading immune responses. Image
Efficacy of #clarithromycin on #COVID19 pneumonia without oxygen administration; protocol for multicenter, open-label, randomized-controlled, 3-armed parallel group comparison, exploratory trial #CAMECOVID
Japan Registry of Clinical Trials jRCTs071210011 Image
The influence of #HLA genotype on the severity of #COVID19 infection
A genetic link has been discovered explaining why some people catch #Covid but don't get sick. The gene is found three times as often in people who are #asymptomatic. Image
Read 199 tweets
🔝5 Concerns about #SARSCoV2 #Biology: A Call to Pause, Deliberate, and Revise Policy─This review is intended both as a basic resource and to initiate an open and critical dialog about SARS-CoV-2 biology for an independent and public call to action.…
Structural basis of ribosomal #frameshifting during translation of the #SARSCoV2 #RNA #genome
A unique feature of the SARS-CoV-2 genome controls protein synthesis and presents an "Achilles heel" of the virus. Image
Brainstem neuropathology in two cases of #COVID19: #SARSCoV2 trafficking between #brain and #lung
Neuropathologic evidence strongly suggests that the pathophysiology of COVID-19 related respiratory failure includes a neurogenic component. Image
Read 213 tweets
It's #MentalHealthAwarenessWeek and i'd like to talk about the role of #SLT in mental health for people with #TBI and #FND. I could speak specifically to the role of SLT in mental health settings as i've previously worked in many but i want to focus on my current client groups
Increasing insight in #TBI recovery can negatively impact mood. Mood and emotions are definitely the remit of neuropsychology but all in the MDT can adapt to support confidence, self esteem and mood 1/n
I use as a basis for my video work with my clients with #TBI and #FND as the focus is on all the super stuff my clients are already doing. VIG has a strong evidence base, and we know clients learn best in a positive environment 2/n
Read 7 tweets
O tweet com id 1125866421316214784 de 2019-05-07 20:54:07 que falava sobre:
🇧🇷✌️ O Deputado Federal Nereu Crispim recebeu nesta segunda-feira (06), em seu escritório de Porto Alegre, a visita do Vice-prefeito de Guaporé, Adalberto João Bastian

#NereuCrispim #Guaporé #Prefeiu...
O bot tentou arquivar o tweet nesse link:
Read 1881 tweets
Los trastornos neurológicos funcionales (TNF)son la conceptualización moderna de la histeria, y aunque su origen nace con la neurología misma, aún en nuestros días el desconocimiento y iatrogenia son muy grandes y los sistemas de salud, rara vez están preparados para atenderles🧵
En octubre de 1885 Freud visita a Charcot en La Salpetriere para aprender sobre sus investigaciones sobre la histeria e hipnosis. Diez años después, junto a Breuer, publicaría su celebre texto "Estudios sobre la histeria", donde acuña el concepto de "Trastorno conversivo"
El Trastorno conversivo se refiere a los estresógenos piscogénicos que se "convierten" en síntomas neurológicos, lo que en palabras de Charcot, era una falla del método anátomo-clínico, suponiendo una lesión "dinámica" cerebral (y no estructural). Hoy la llamamos "funcional".
Read 16 tweets
Reducing #COVID19 #Airborne #Transmission Risks on #PublicTransportation Buses
Wearing of #facemasks reduced the overall particle count released into the bus by an average of 50%, the dispersion distance by several feet and #aerosol particles by 84.36%. Image
🔝#SARSCoV2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis
#COVID19 can kill heart muscle cells, interfere with contraction. Details of how #coronavirus infects #heart: models of tissue damage may help develop potential therapies. Image
High-content screening of coronavirus genes for innate immune suppression reveals enhanced potency of SARS-CoV-2 proteins
196 protein products of seven coronaviruses: the genes encoded by #SARSCoV2 are generally more potent immune suppressors than others Image
Read 236 tweets
I am extremely impressed by the incredible resilience of the #FNDtwitter community. Dealing with a difficult to manage diagnosis, poor access to care and on top of this being bullied by other patients/patient advocates, they speak the truth and don't let themselves be silenced.
I am honored every day to help patients understand #FND in its complexities, develop a treatment plan that addresses core symptoms and comorbidities and work together towards better quality of life. @FNDHope
Denying the validity of a functional neurological disorder diagnosis is short-sighted and not helpful for patients. In fact, much harm can be done when FND goes undiagnosed/misdiagnosed and mistreated.
Read 6 tweets
Functional Gait disorders ("FGD" for the purpose of this #twittorial) are common and disabling, usually accompanied by other symptoms. FGD are challenging for the non #MovDis physician and it can difficult to determine #inconsistencies and #incongruencies during examination.
A good approach is to identify #clinicalSigns to differentiate a #functional vs #organic cause

#Inconsistency is the variability in gait disorder severity over time.
#incongruency involves a combination of symptoms and sins not seen in organic disorders.
Read 19 tweets

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