FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Episode, Flare and Available-Capacity Planning

Page role: Additional flare-planning guidance. Develops the original unnumbered episode/flare guidance and available-capacity planning; it is not a new sensory-restoration technique. See the collection index for the original technique groupings.

Most likely fit: Sensation fluctuates or changes in familiar episodes, interrupting activity or creating hazards before a technique can be used. [Clinical consensus and individualized care planning; no universal onset strategy]

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For the Person With FND

What this approach is for

Sensory symptoms may be persistent, fluctuate through the day or appear in episodes. A useful plan distinguishes your familiar pattern from changes needing medical attention. It can be very short.

Available capacity means the physical, cognitive and sensory resources you have available for what is happening now. It is a practical planning idea, not a measurable diagnosis or a rule that explains every flare. A flare may happen without a warning or obvious cause.

Terms in everyday language

Sensory symptoms concern bodily feeling; a flare describes a period when symptoms are worse. Loss of awareness, seizure events, sudden falls and paralysis may require their own assessed plans. A distant-feeling limb is not automatically the same thing as dissociation.

A practical example and flare adaptations

A short plan might say: put down hazards; sit or support the affected area if needed; reduce a specific overwhelming demand; then choose one familiar, tolerable cue only if useful. If there is no warning, the fallback is protection and help, not a missed chance to prevent the event.

Once ready, return through a simpler version of the interrupted activity. Leave time for the later response. There is no need to catch up on missed practice. Continuing accommodations, rest or support may be the right outcome for that day.

These are choices to discuss with your care team, not a required exercise schedule. Helpful activity, comfort and access matter even when sensation remains altered. The evidence and its limits are explained below. (Sources: 1, 2)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Family, Friends, and Other Supporters

Learn the person’s brief plan and their preferred way to ask for help. Use one calm prompt rather than repeatedly asking what they can feel. Avoid surprise touch or stimulation intended to bring sensation back.

If no technique is possible, protect the person and follow the agreed response. A new or clearly different event needs reassessment; do not assume that familiar FND explains it.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

For Clinicians and the Care Team

Selection and assessment

Document onset, duration, distribution, warning, associated symptoms, activity demands, recovery and differences from baseline. Use proportionate observation rather than burdensome symptom monitoring. Coordinate with seizure, migraine, motor and dissociation plans when these overlap.

Explicit procedure

  1. Agree the established pattern and the changes that require urgent reassessment.
  2. List the immediate hazards created by sensory loss or hypersensitivity.
  3. Choose a short onset response and a no-warning fallback.
  4. Select at most one rehearsed sensory or task strategy if the person finds it useful.
  5. Plan a supported return, including who completes essential activities when capacity is limited.
  6. Review after a changed pattern, injury or prolonged deterioration and revise the treatment demands as needed.

Review, progression and stopping

Measure safety, clarity of support, access to essential activities and tolerability of the plan. Recurrence does not erase earlier gains or prove failure. If symptoms remain severe, continue care, accommodations and follow-up rather than requiring more effort before support is offered.

The procedures are educational implementation examples requiring clinical adaptation, not validated standalone protocols. (Sources: 1, 2)

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —

Research and Sources

OT consensus supports individualized routines, adaptation and relapse planning. The sequence on this page is an educational planning aid; it has not been validated as a way to prevent functional sensory episodes.

Citation Full citation
[1] Nicholson C, Edwards MJ, Carson AJ, et al. Occupational therapy consensus recommendations for functional neurological disorder. JNNP. 2020;91:1037–1045. FND-CIT-0011. Source
[2] Nielsen G, Higgins R, Stone J, Coebergh J, Edwards MJ. Functional sensory symptoms and signs: a case-control study of 102 patients. Brain Communications. 2026;8(1):fcag031. FND-CIT-0023. Source

Source check: September 15, 2026 · Occupational-therapy, physiotherapy, neurology, pain, equipment, lived-experience, supporter and accessibility review pending.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources —