Functional Neurological Disorder (FND) is a disability thought to be caused by extreme emotional stress rather than a neurological or physical disorder. FND can present in drastic ways such as blindness, falls, catatonic states, numbness, paralysis, limb injuries, or a sudden onset of tics. The symptoms are real and often impact overall quality of life for patients and their families. CBIT Therapy provides support for tics related to FND with occupational therapy strategies and training in Comprehensive Behavioral Intervention for Tics, also known as CBIT. Patients learn to shift attention away from their disabling symptoms and to reduce the frequency and intensity of tics through their own actions and abilities.
FND tics can improve following a diagnosis of the disorder, reassurance that symptoms are not caused by an underlying medical problem, and validation that the symptoms are real. Patients also benefit from CBIT, not watching social media with tic content, and reducing stressors.
Obtaining a diagnosis of Functional Neurological Disorder (FND) can be extremely confusing and overwhelming. A team approach is required to clearly identify needs and to outline the steps needed to move forward. Specialists may include neurologists, psychiatrists, psychologists, social workers, and physical therapists. Occupational therapists (OTs) also enable patients to gain independence and wellbeing through a habit reversal program based on CBIT. Patients learn direct actions that they can do to manage the tics, as well as stress management and coping skills to prevent new symptoms.
Stress leading up to FND may have accumulated over many years or may be the direct result of one traumatic event. During the pandemic there has been a huge increase in tween and teen girls experiencing tics. Many report feelings of loss, anxiety, loneliness, and uncertainty about their futures. Those who have also watched videos with false content related to tics often have a form of FND sometimes called TikTokTics. These tics are easy for specialists to recognize because the movements tend to mirror those viewed on screen. Therapist see the same tics over and over and hear the same vocalizations and very specific words. A number of these patients also demonstrate similar odd behaviors such as throwing eggs while baking. Frequently those with TikTokTics find both alarm and humor in their tics. They also find companionship by posting their own videos and engaging in online forums to discuss their symptoms, often exacerbating the situation.
Functional Neurological Disorder (FND): a patient's guide neurosymptoms.org
Decoding a Disorder at the Interface of Mind and Brain Scientific American
Pathophysiology of Functional Neurological Disorder BMJ Talk Medicine Podcast
Occupational Therapy Consensus Recommendations For Functional Neurological Disorder Journal of Neurology, Neurosurgery, and Psychiatry
FND Support Group FND Hope US
TikTokTics Online OTs
CBIT Therapy is part of Online OTs LLC and collaborates with clinicians at UMass, MGH, Boston Children's Hospital, and many practices throughout New England. We request that all patients consult a neurologist prior to receiving therapy to determine the cause of their tics and to ensure proper medical care. A HIPPA compliant Google Suite platform is used for video calls. Allways Health Partners, Blue Cross Blue Shield, and private pay are accepted. Mass Health recipients are eligible for some financial assistance.
Please FAX referrals to 857-202-5085. Thank you!