Speech Pathology, Flinders University, Adelaide, South Australia, Australia.
University of Technology Sydney, Sydney, New South Wales, Australia.
J Neurol Neurosurg Psychiatry. 2021 Oct;92(10):1112-1125. doi: 10.1136/jnnp-2021-326767. Epub 2021 Jul 1.
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 adults and young people. An international panel of speech and language professionals with expertise in FND were approached to take part. Participants responded individually by email to a set of key questions regarding best practice for assessment and interventions. Next, a video conference was held in which participants discussed and debated the answers to these key questions, aiming to achieve consensus on each issue. Drafts of the collated consensus recommendations were circulated until consensus was achieved. FND should be diagnosed on the basis of positive clinical features. Speech and language therapy for FND should address illness beliefs, self-directed attention and abnormal movement patterns through a process of education, symptomatic treatment and cognitive behavioural therapy within a supportive therapeutic environment. We provide specific examples of these strategies for different symptoms. Speech and language professionals have a key role in the management of people with communication and related symptoms of FND. It is intended that these expert recommendations serve as both a practical toolkit and a starting point for further research into evidence-based treatments.
由于功能性神经障碍（FND）而引起的交流问题（例如发音困难、言语不流畅、语言和发音障碍）、吞咽障碍（吞咽困难和球感）、咳嗽和上呼吸道症状，是言语治疗师经常会遇到的问题。然而，文献中对于最有效的实用管理方法的描述却很少。本共识文件旨在为评估和干预提供建议，这些建议与成年人和年轻人都相关。我们邀请了一组在 FND 方面具有专业知识的国际言语治疗师参与。参与者通过电子邮件单独回复了一系列关于评估和干预最佳实践的关键问题。然后，我们举行了视频会议，参与者在会议上讨论和辩论了这些关键问题的答案，旨在就每个问题达成共识。在达成共识之前，我们会传阅草稿，以收集反馈。应根据阳性临床特征诊断 FND。针对 FND 的言语治疗应该通过教育、对症治疗和认知行为疗法，在支持性的治疗环境中，解决疾病信念、自我指向性注意和异常运动模式等问题。我们为不同的症状提供了这些策略的具体示例。言语治疗师在 FND 患者的交流和相关症状管理中具有关键作用。我们希望这些专家建议既可以作为实用工具包，也可以作为进一步研究基于证据的治疗方法的起点。
