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FMD Diagnostic Clinic Opens

Functional Movement Disorder (FMD) is a subtype of Functional Neurological Symptom Disorder (FNSD) with primarily motor symptoms (Espay et al. JAMA Neurol 75(9):1132-1141)

Patients present to clinics throughout the Johns Hopkins Health System with abnormal involuntary movements suspicious for FMD. The FMD Diagnostic Clinic aims to fill an unmet need within Johns Hopkins Medicine for providers and patients with suspected FMD to get comprehensive and multidisciplinary neurological and neuropsychological evaluation. An evaluation in the FMD Diagnostic Clinic aims to clarify diagnosis, develop a formulation to guide treatment planning, and provide patients and their providers with treatment recommendations.

When to suspect FMD: Suggestive clinical features of FMD include sudden onset of movement symptoms, disappearance with distraction, increase with attention, and excessive fatigue or demonstration of effort. A formal diagnosis is made after neurological examination demonstrating inconsistencies (e.g., changing patterns of symptoms over time with susceptibility to distraction) and/or incongruence (e.g., a clinical picture neuroanatomically incompatible with known organically determined patterns). How to refer to FMD Diagnostic Clinic: Place order “Ambulatory referral to Neurology” and specify:

Follow-up care: The FMD diagnostic clinic is for one-time diagnostic evaluations. That said, patients are referred to services appropriate for their care. This may include follow-up with rehabilitation therapies (PT, OT, SLP), psychotherapy, or other services inside and outside of the Johns Hopkins system.  We aim to connect them with providers familiar with the FND care. We do not follow patients longitudinally in this clinic.

 

 

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Kelsey Bennett

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