Before referring functional neurological disorder (FND) patients to the Neurology department, please follow the relevant referral guidance.
Patient has a known functional neurological disorder
There is currently no therapeutic service for functional neurological disorders (FNDs) at University Hospitals Birmingham NHS Foundation Trust (UHB).
If the patient is:
- under active follow up with a neurologist at UHB, please contact the consultant directly, but be aware they may not have any better access to therapeutic services which are designed to help
- not under active follow up at UHB, please contact the patient's previous neurologist or refer the patient to neuropsychiatry services at Birmingham and Solihull Mental Health Trust (BSMHFT)
Please try not to refer patients to general neurology at UHB for a second opinion. Advice on getting a second opinion is outlined in the 'Patient diagnosed with a FND requires a second opinion' section.
Patient diagnosed with a functional neurological disorder requires a second opinion
There is currently no therapeutic service for functional neurological disorders (FNDs) at University Hospitals Birmingham NHS Foundation Trust (UHB).
UHB do not have any neurologists who specialise in FNDs. Details of specialist FND services can be found on the FND Action website and an interactive map of FND providers is available on the FND Hope website.
The misdiagnosis rate for FND is less than 4% and may, with modern imaging and other diagnostic tests, be less than 1%.
UHB's neurologists work closely with colleagues in other centres and if they feel that a second opinion is needed, they will make the referral themselves.
If the patient doesn’t accept the diagnosis of FND and wants a second opinion, we would ask that you either write to a named neurologist or refer the patient to one of the specialist services listed on the FND Action website.
Patient suspected of having a functional neurological disorder
Functional neurological disorder (FND) is becoming better understood and more widely recognised by patients and clinicians.
Many patients have functional symptoms without having full-blown FND. Many patients have a variety of symptoms that accompany migraine for example.
Not everyone with functional symptoms need to be referred to Neurology. If the patient is concerned about the possibility of multiple sclerosis (MS), but is not disabled by their symptoms, often an MRI scan and reassurance can be enough. This may be accessed via the advice and refer (A&R) service.
If the patient has a significant disability and you are not sure whether the diagnosis is FND, we can see them in Neurology and confirm or investigate the diagnosis. Please see the guidance page on how to make a Neurology referral.
Prior to the referral, please explain to the patient that you suspect FND. Pending the appointment, please direct the patient to the FND resources page.
If FND is diagnosis and the patient has significant disability they may be referred to the Neuropsychiatry team at Birmingham and Solihull Mental Health Trust (BSMHFT).
Last reviewed: 06 September 2024
