2021
DOI: 10.1136/jnnp-2021-326767
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Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy

Abstract: Communication problems (eg, dysphonia, dysfluency and language and articulation disorders), swallowing disorders (dysphagia and globus), cough and upper airway symptoms, resulting from functional neurological disorder (FND), are commonly encountered by speech and language professionals. However, there are few descriptions in the literature of the most effective practical management approaches. This consensus document aims to provide recommendations for assessment and intervention that are relevant to both adul… Show more

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Cited by 68 publications
(40 citation statements)
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“…For example, gastroenterologists, respiratory physicians, and otolaryngologists all see patients with functional communication, swallowing, cough, and related disorders. Peer-reviewed literature A concerted effort has been made to publish clinical neurology handbooks [36] , consensus criteria, expert opinion articles, updates on etiology, assessment, and treatment of FND subtypes [23] , [37] , [38] , [39] , [40] , and articles describing the clinical assessment process [41] , [42] . Use of video teaching resources within all levels of education Video teaching resources can be helpful in teaching about patterns of presentation, the neurology examination, and interviewing skills.…”
Section: The Referral Process: Educational and Structural Interventions To Promote Changementioning
confidence: 99%
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“…For example, gastroenterologists, respiratory physicians, and otolaryngologists all see patients with functional communication, swallowing, cough, and related disorders. Peer-reviewed literature A concerted effort has been made to publish clinical neurology handbooks [36] , consensus criteria, expert opinion articles, updates on etiology, assessment, and treatment of FND subtypes [23] , [37] , [38] , [39] , [40] , and articles describing the clinical assessment process [41] , [42] . Use of video teaching resources within all levels of education Video teaching resources can be helpful in teaching about patterns of presentation, the neurology examination, and interviewing skills.…”
Section: The Referral Process: Educational and Structural Interventions To Promote Changementioning
confidence: 99%
“…For these children, the somatic narrative potentially includes the following neurophysiological processes and any associated symptoms: activation or dysregulation of the stress system (e.g., upregulation of the autonomic nervous system and increases in cortical arousal) [49] , [54] , [55] , [56] ; changes in homeostatic setpoints (e.g., lowering of pain thresholds and changes in regulation of PCO2 secondary to hyperventilation) [57] , [58] , [59] ; activation of the body’s protective (alarm) systems (e.g., pain and fatigue) that signal a need for protective action [60] , [61] ; and changes in neural networks (see previous subsection). The narrative also includes the positive signs (e.g., entrainment of tremor or incongruity and reversibility of voice or other motor symptoms) that distinguish functional neurological symptoms from other neurological conditions [37] , [38] and that reflect the disruption within and between neural networks controlling emotion processing and motor and sensory processing (see previous subsection). In sum, the somatic narrative provides the pediatrician with valuable information about changes in the child’s body function in response to stress, threat, or danger, whether actual or perceived.…”
Section: Brain Mind and Body: Reconceptualizing Fndmentioning
confidence: 99%
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“…Sharing self-help resources, explanatory websites, patient advocacy connections and other written material can further solidify a path forward. See Table 2 [20] , [21] , [22] , [23] , [24] , [25] , [26] Sharing clinical notes with patients where the diagnosis is confirmed is another way to be transparent and continue the educational dialogue.…”
Section: Communicating the Diagnosismentioning
confidence: 99%