Between brain and mind: Unpackaging Functional Neurological Disorders with Dr Sarah Lidstone

Ditch The Labcoat

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Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University.

Welcome to another enlightening episode of "Ditch the Lab Coat," where we delve into the complexities of healthcare with a sharp, science-based skepticism. I'm your host, Dr. Mark Bonta, and today we're joined by the brilliant movement disorders neurologist, Sarah Lidstone.

In this episode, we explore the intricacies of Functional Neurological Disorders (FND), a condition where the brain's function fails despite appearing normal on tests. We'll unpack the pivotal role of interdisciplinary care in treating FND, the significance of recognizing symptoms and triggers, and the essentiality of patient acknowledgment for effective therapy.

Sarah shares her expertise on the communication breakdowns in brain networks that lead to functional symptoms, and how historical misconceptions have shaped the treatment of such disorders. We critique the healthcare system's often dismissive attitude and discuss strategies to improve provider skills and patient outcomes.

Listen as we discuss real-world examples, like dissociative seizures versus epileptic seizures, and the nuanced clinical examinations that differentiate them. We'll also dive into therapy misconceptions and the importance of supporting patient agency in the recovery process.

Whether you’re a healthcare professional or simply intrigued by the mind-body connection, this episode promises to be an engaging and insightful journey into the world of FND. So, grab your headphones, and let's ditch the lab coat for an hour and uncover the fascinating science behind these complex disorders. Tune in now!

07:33 – FND highlights healthcare system's shortcomings and improvements.

12:38 – Testing rules out comorbid neurological conditions, non-lesional deficits.

20:07 – Societal attitudes challenge understanding of functional disorders.

22:08 – FND misdiagnosis: historical misunderstanding, lacking clinical home.

30:04 – Emotional challenges diagnosing psychogenic, non-epileptiform seizures.

36:45 – Distinguishing seizures can be challenging and nuanced.

38:26 – CBT helps control seizures, reducing emergency visits.

47:34 – Support patients' agency and structure healthcare systems.

51:57 – Recognizing symptom changes enables better treatment understanding.

56:11 – Functional neurological disorders often face systemic dismissal.

59:37 – Body worked fine despite previous dysfunction experience.