Interprofessional approach to the management of functional neurological symptoms with co-morbid concussions and hypermobility syndrome: a case report

Abstract

Clinical education scenario: This case report describes the individualized treatment approach and clinical reasoning of a residency-trained physical therapist for an adolescent girl with symptoms of functional neurological symptom disorder (FNSD). Rationale for case study: There are limited research studies regarding successful treatment of pediatric FNSD. This case study provides evidence for an interprofessional treatment approach of an adolescent with symptoms of FNSD, including the role of a residency-trained physical therapist. Case description: A 15-year-old girl with symptoms of FNSD, multiple comorbidities, and history of concussions participated in an interprofessional treatment program lasting 1 year. Her treatment was assessed using the Energy Expenditure Index, Timed Up and Down Stairs, Five-Times Sit to Stand, 6-Minute Walk Test, and Functional Disability Index. The patient demonstrated improvement in all outcome measures post-treatment. Implications: The patient’s function was restored using an interprofessional treatment approach, which emphasized interpersonal communication. While future studies are needed to assess the efficacy of this treatment approach, this case report demonstrates that physical therapy residency training prepares a clinician to effectively treat complex patients with multi-system involvement.