Recovery and Management Technique Index

Labels: R research-supported · C clinical consensus · E emerging · L repeated community report. A label applies to the technique or treatment approach named, not to a promise of recovery.

This index includes treatment options, rehabilitation components and supporting care. Its entries are not a count of distinct proven treatments. The history audit maps the original lists to the expanded pages and identifies additions.

Techniques by symptom

Functional limb weakness

• Automatic and task-oriented movement for movement that is more available inside a familiar action than during isolated strength testing. [Clinical consensus]
• External focus and divided attention for movement that becomes easier with a destination, rhythm or safe second task. [Clinical consensus]
• Supported loading and weight-bearing for difficulty accepting weight through a leg despite some available stance control. [Clinical consensus]
• Step initiation from weight shift when standing is possible but the first step feels blocked. [Clinical consensus]
• Foot sliding when floor contact makes limb advancement easier than toe clearance. [Clinical consensus]
• Backward walking as a bridge when guarded backward stepping reveals a smoother pattern that may transfer to forward gait. [Clinical consensus]
• Treadmill and body-weight-supported walking when external rhythm or partial unloading enables repeated stepping. [Clinical consensus]
• Mirror and visual feedback when selected visual information improves a task without increasing symptom monitoring. [Clinical consensus; direct component evidence is limited]
• Meaningful upper-limb and two-handed tasks when the arm or hand contributes more naturally to stabilizing or manipulating an object. [Clinical consensus]
• Graded activity and reconditioning when deconditioning or reduced tolerance adds to the motor limitation. [Clinical consensus; no universal dosing formula]
• Electrical stimulation as an adjunct when a trained clinician identifies a specific movement that may benefit from a timed sensory or motor cue. [Emerging and uncertain evidence]
• Relapse and self-management planning for episodic, fluctuating or persistent weakness requiring a safety, fallback and return plan. [Clinical consensus; supported as one component of structured rehabilitation]

Functional tremor

• Voluntary tremor retrainment for a rhythmic limb movement that can be deliberately reshaped by changing its speed or size and then slowing it toward stillness. [Emerging evidence from a small proof-of-concept study; supported by clinical consensus]
• Competing rhythm and entrainment practice when another limb’s beat changes tremor enough to create a bridge into function. [Clinical consensus; informed by entrainment research, with limited direct component evidence]
• External focus and meaningful-task practice when handling a safe object or moving toward a result is more effective than monitoring the tremor. [Clinical consensus]
• Posture, alignment and movement-pattern adjustment when a repeatable joint position, grip, support or loading pattern changes tremor interference. [Clinical consensus]
• Contract–release and muscle relaxation when excess bracing or co-contraction adds effort around the tremoring joint. [Clinical consensus; direct component evidence is limited]
• Mirror and visual feedback when brief visual information improves alignment, rhythm or weight distribution without increasing monitoring. [Clinical consensus; direct component evidence is limited]
• Surface-EMG biofeedback when a clinician-selected muscle-activity signal supports release of unnecessary recruitment and functional transfer. [Clinical consensus; direct functional-tremor treatment evidence is limited]
• Individualized whole-person treatment when motor rehabilitation needs coordination with occupational, psychological, communication or other care. [Programme-level research and multidisciplinary clinical consensus; no single combination fits everyone]
• Relapse and self-management planning for a familiar episodic, fluctuating or persistent tremor requiring safety, fallback and graded-return instructions. [Clinical consensus; supported as one component of structured rehabilitation]

Functional jerks or myoclonus

• Pattern and warning mapping for a recognizable context, cluster, sensation, posture or muscle change that may reveal an earlier treatment entry point. [Clinical consensus]
• Early attention redirection when a familiar warning gives enough time to begin one safe external task before the usual jerk or cluster. [Clinical consensus; only when a usable warning exists]
• Competing and continuous movement when a brief jerk emerges from a recognizable posture while a smooth purposeful movement can remain more organized. [Clinical consensus; direct component evidence is limited]
• Pain and muscle-overactivity management when pain, cramp, protective bracing or excess activity between jerks is a separate barrier requiring assessment. [Clinical consensus; treatment must follow the identified condition]
• Meaningful functional-task practice when repeated suppression increases effort while a safe daily action provides a more useful movement goal. [Clinical consensus]
• Graded activity and load planning when bouts interact with fatigue, pain, deconditioning or an unsustainable physical, cognitive or sensory load. [Clinical and occupational-therapy consensus; no universal dosing formula]
• Arousal and startle regulation only when surprise, anticipatory bracing or a high-alert state reliably increases the individual’s familiar jerks. [Clinical consensus; relevant only when arousal or startle is part of the individual pattern]
• Episode safety and relapse planning when clusters create injury or object-dropping risk or require setting-specific instructions and a no-warning fallback. [Clinical consensus; supported as a component of structured rehabilitation]
• Individualized multidisciplinary treatment when movement work must be coordinated with daily-task adaptation, psychological care when relevant, or treatment of coexisting conditions. [Programme-level research and clinical consensus; functional-jerk-specific controlled evidence is lacking]

Functional Tics and Tic-Like Symptoms

• Positive explanation and a shared plan — Ask the clinician to explain what supports the diagnosis, what remains uncertain and what help is available. Agree on one or two goals that matter to you, such as finishing a conversation or getting through a meal more comfortably. [Clinical consensus]
• Brief pattern and context mapping — If useful, note a few examples of what happened before, during and after symptoms, including discomfort, urges, surroundings and other people’s responses. Stop if tracking makes life revolve around symptoms; no warning or trigger has to be found. [Assessment and treatment-planning component; clinical consensus]
• Individually formulated behavioral or psychological treatment — A clinician familiar with both tics and FND can discuss an approach suited to your symptoms and priorities. I-CBiT combines several methods and has early case-series evidence. Its exercises, including exposure and response prevention, need individual assessment and consent; this page is not a home suppression programme. [Emerging evidence; uncontrolled series of eight young people]
• Supported return to routines and valued activity — Choose a manageable way to stay involved in something important, with breaks, help or adaptations as needed. Review effort, pain and recovery cost. Participation does not have to wait until symptoms disappear. [Clinical consensus; individualized rehabilitation principle]
• Coexisting-condition and medication review — Review a possible primary tic disorder, ADHD, OCD, anxiety, depression, pain, sleep difficulty or other FND when relevant. Medication may treat a coexisting condition; it is not automatically a treatment for the functional symptom mechanism. Change medicines only with the prescriber. [Coordinated care; clinical consensus]
• Motor and vocal safety and communication planning — Plan safer handling of hot or sharp objects, seating and other tasks affected by movements. For vocal interruptions, agree how to finish a message: time, a pause, typing or writing may help. Accommodations protect access even when symptoms continue. [Safety and access planning; not a separately proven treatment]
• Family, school and workplace response planning — Agree who should know, what help you want and how others should respond. Options include a private break space, alternative presentations and a simple explanation of involuntary words. Avoid punishment, shame or demands to suppress symptoms to earn access. [Support and accommodation planning]
• Tic-attack, cluster and flare planning — For familiar intense bouts, agree how to reduce immediate hazards, offer calm support, allow recovery and recognize a change needing assessment. A prolonged bout is not automatically a functional seizure. A plan should work even when there is no warning. [Safety and relapse planning; clinical consensus]

Functional dystonia or fixed posturing

• Supported positioning and non-forceful release when pain, strong bracing or worsening with passive pulling makes a fully supported, non-corrective starting position most appropriate. [Clinical consensus]
• Position and gravity change when movement becomes more available lying, sitting, leaning or with the limb supported, creating a bridge toward the needed position. [Clinical consensus]
• External focus and automatic movement when purposeful reaching, rolling, transferring or stepping is more organized than direct commands to straighten or relax. [Clinical consensus]
• Graded weight-bearing and functional use when a hand or foot avoids contact or can accept a little supported load but not yet participate fully in a task. [Clinical consensus]
• Graded sensory reintroduction when fabric, footwear, touch, pressure or object contact is unusually unpleasant and limits use. [Clinical consensus; direct functional-dystonia component evidence is limited]
• Mirror and visual feedback when a brief view improves joint-position accuracy or task alignment without encouraging constant symptom checking. [Clinical consensus; direct functional-dystonia component evidence is limited]
• Surface-EMG biofeedback when a selected superficial muscle-activity signal helps the person reproduce a useful release or timing change. [Clinical consensus; direct functional-dystonia treatment evidence is very limited]
• Electrical stimulation as an adjunct when a clinician identifies a specific sensory or motor cue that improves one functional action and can be faded. [Emerging and uncertain evidence; use only as a clinician-selected adjunct]
• Pain, skin, joint-range and contracture management when a secondary complication has become a distinct barrier to movement, care or participation. [Clinical consensus; management must follow the identified complication]
• Splint, orthosis, footwear and mobility-equipment review when a device has a defined protection, safety or access goal, or existing equipment is painful, poorly fitting or function-limiting. [Clinical consensus; equipment requires a defined goal and regular review]

Additional treatment-review and care pages (outside the original numbered list):

• Additional specialist treatment review: Specialist botulinum-toxin review only when a specialist identifies a specific target and functional goal or a coexisting nonfunctional dystonia. [A small pilot randomized trial found no added benefit over placebo before cognitive behavioural therapy; selected use remains uncertain]
• Additional care-planning guidance: Episode, flare and relapse planning when posturing is intermittent, changes sharply or returns after improvement and needs a safety, no-warning fallback and graded-return plan. [Clinical consensus]
• Additional coordinated-care guidance: Individualized multidisciplinary treatment when movement work must be coordinated with pain, daily activities, psychological care when relevant, equipment, work or treatment of coexisting conditions. [Small case-series, pilot-trial and programme-level evidence plus multidisciplinary clinical consensus; no single package fits everyone]

Functional gait disorder

• Rhythmic weight shift and step initiation when the body does not transfer smoothly onto one leg, the other foot feels unable to begin or a knee buckles during hesitant starting. [Clinical consensus; direct component evidence is limited]
• Foot sliding or “skating” progression when a foot feels stuck, the leg drags or deliberate lifting increases bracing, while surface contact permits forward travel. [Clinical consensus; direct component evidence is limited]
• Speed and continuous-walking transformation when a very slow, stop–start pattern becomes smoother at another individually assessed safe pace. [Clinical consensus; direct component evidence is limited]
• Backward, sideways and direction-change walking when forward walking is disproportionately difficult but an alternative direction accesses a more organized step. [Clinical consensus; not helpful or safe for everyone]
• External rhythm and auditory cueing when irregular timing or repeated stopping improves with a comfortable count, beat or other accessible timing signal. [Clinical consensus; no functional-gait trial isolates auditory cueing]
• Exaggerated movement and marching when low clearance, dragging, short steps, crouching or stiffness changes with a deliberately different movement that can be shaped toward ordinary gait. [Clinical consensus; direct component evidence is limited]
• External focus and purposeful dual-task walking when monitoring each leg worsens walking but a destination or simple meaningful task supports automaticity without compromising safety. [Clinical and occupational-therapy consensus]
• Stairs as a supervised bridge only when formal assessment finds a stair step safer or more automatic than level gait and appropriate rails and guarding are available. [Clinical consensus; stairs carry greater mechanical and fall demands]
• Treadmill and body-weight-supported walking when a moving belt supports continuity or a harness provides the unloading or fall protection needed for safe repetition. [Clinical consensus; direct device-specific evidence in functional gait disorder is limited]
• Mirror and visual feedback when an external view of one selected alignment or movement variable simplifies the task without increasing visual or body-focused symptoms. [Clinical consensus; direct component evidence is limited]
• Graded community walking and environmental complexity when clinic gait does not transfer to meaningful home, outdoor, crowded, visually busy or uneven settings. [Clinical and occupational-therapy consensus; supported only as part of broader rehabilitation programmes]
• Mobility aids, guarding and fall planning when buckling, swaying, sudden gait loss, fatigue or injury risk requires fitted equipment and a setting-specific safety plan. [Clinical consensus; falls assessment is supported by observational evidence]
• Individualized FND-informed rehabilitation and relapse planning when gait disability requires selected movement techniques, conditioning or daily-task adaptation, coexisting-condition care and a written setback plan. [Functional-gait-specific and mixed functional-motor programme evidence; no single component is established as the active ingredient]

Functional seizures

• Diagnostic Explanation and Continuing Care — Ask how the diagnosis was established for each event type and leave with a written explanation, a treatment contact and follow-up. [Clinical guideline recommendation; explanation alone is not an established seizure-stopping treatment]
• Individualized Episode Safety Plan — Prepare the surroundings and response for shaking, still or unresponsive events, especially when there is no time to act on a warning. [Clinical safety guidance; not a method for forcing an episode to stop]
• Warning and Pattern Mapping — Use a brief, low-burden record to find a usable early cue or recovery need; a trigger or remembered warning may never be identifiable. [Specialist clinical guidance; no requirement to find a trigger]
• Sensory Grounding and an Attention Anchor — At a familiar warning with enough awareness, try one tolerable visual or touch cue already practised in safety; skip cues that add sensory overload. [Specialist clinical guidance; individual grounding variants lack isolated efficacy evidence]
• Seizure-Focused Psychological Treatment — Choose a structured programme around the person’s goals, such as episode coping or returning to activities, with an honest discussion of mixed trial outcomes. [Research-supported programmes with mixed outcomes; individual components are not independently proven]
• Clinician-Taught Breathing Control — Seek respiratory assessment and comfortable, supervised practice when breathing patterns may be relevant; do not improvise breath-holding or deep-breathing drills. [Emerging evidence; a published randomized-trial protocol is not an efficacy result]
• Coexisting-Condition and Load Review — Address a specific untreated condition or practical burden, such as pain, sleep disruption or difficult access to care, even when seizures continue. [Clinical guideline and multidisciplinary care; benefits for another condition do not prove a seizure effect]
• Prescriber-Led Medication Review — Clarify the purpose of every regular and rescue medicine and arrange supervised changes only when indicated, including separate treatment for coexisting epilepsy. [Clinical guideline recommendation; no unsupervised withdrawal]
• Supported Return to Activities — Adapt one valued activity for event unpredictability, fatigue and safety, preserving the aids and help that make participation possible. [Clinical and occupational-therapy guidance; programme evidence does not establish a fixed activity dose]

Additional treatment-review and care pages (outside the original numbered list):

• Additional age-specific treatment page: ReACT for Children and Adolescents — Consider a clinician-delivered paediatric programme with an individualized response and family plan; its evidence does not establish the same approach for adults. [Emerging paediatric programme evidence; do not generalize directly to adults]
• Additional supporter-planning guidance: Supporter Response Rehearsal — Talk through the agreed response with chosen supporters between events, including who stays, who helps and when medical escalation is needed. [Clinical guideline and safety guidance; rehearsal is an implementation aid]
• Additional recovery-planning guidance: Recovery, Cluster and Flare Planning — Separate the visible event from prolonged recovery or surrounding symptoms and plan safe transfers, communication and reassessment for a changed pattern. [Individualized clinical care; distinguish familiar recovery from a new medical problem]

Functional sensory symptoms

• Graded Sensory Input for Reduced or Altered Sensation — Contact feels faint, absent or unfamiliar, and a safe, tolerable input can be paired with a simple task. [Clinical consensus; the particular practice sequence is an educational adaptation, not a tested standalone treatment]
• Desensitization for Painful Touch and Hypersensitivity — Clothing, washing or another normally non-painful contact hurts or overwhelms the person after relevant causes have been assessed. [Clinical consensus; direct evidence for an isolated FND desensitization protocol is limited]
• Sensory Discrimination: Texture, Location and Object Recognition — Touch is detectable but difficult to interpret, distinguish or connect with a familiar object. [Clinical rehabilitation adaptation; FND-specific component efficacy is uncertain]
• Pairing Sensation With Meaningful Movement — An altered-feeling hand or foot is difficult to use, but a supported, useful task is possible. [Clinical and occupational-therapy consensus; programme principles do not prove sensory recovery]
• Graded Return to Clothing, Footwear and Everyday Contact — A particular necessary contact is avoided or shortened because it is unpleasant, even though a smaller version may be manageable. [Clinical consensus; use an individualized goal and retain necessary accommodations]
• Visual and Mirror Feedback for Altered Body Sensation — Watching an affected area helps locate it or perform a safe task without increasing visual discomfort or disconnection. [Clinical rehabilitation adaptation; direct FND sensory-specific mirror evidence is uncertain]
• External Attention and Task Focus — Repeatedly checking a familiar altered sensation disrupts an otherwise safe activity, and a simple external cue is tolerable. [Clinical consensus principle; no isolated sensory-symptom efficacy claim]
• Sensory-Profile Assessment and Environmental Adaptation — Multiple forms of sensory input interfere with washing, appointments, rest or other activities, and a tailored OT assessment is needed. [Emerging sensory-based OT evidence; uncontrolled cohort outcomes do not establish causation]
• TENS and Electrical Stimulation: Specialist Review and Safety — A qualified clinician is considering electrical input for a specific pain or rehabilitation goal and needs to establish whether it is suitable. [Emerging and uncertain FND evidence; safety review is essential]
• Coexisting Pain, Migraine and Medical Review — Burning, pain, spreading numbness or sensory overload may have more than one contributor, or a changed pattern needs reassessment. [Clinical assessment and coordinated-care consensus; treatment follows the condition identified]

Additional treatment-review and care pages (outside the original numbered list):

• Additional injury-protection guidance: Skin, Pressure and Injury Protection — Reduced sensation makes heat, cuts, pressure or footwear injury difficult to notice, including during temporary episodes. [Clinical safety adaptation; protection is supportive care rather than a proven sensory-restoration treatment]
• Additional flare-planning guidance: Episode, Flare and Available-Capacity Planning — 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]

Functional visual symptoms

Nine original entries, nine detailed pages; see the collection mapping.

• Positive Explanation of Preserved Vision and Follow-Up — The person has an assessed functional visual-loss pattern and needs to understand the positive findings, remaining uncertainty and continuing-care plan. [Specialist clinical guidance; explanation is not a guaranteed vision-restoring treatment]
• Noticing Briefly Better Vision Without Repeated Testing — Occasional useful visual moments occur naturally and can help identify a workable task or setting without increasing checking. [Specialist clinical guidance; no isolated efficacy evidence]
• Orthoptist-Guided Visual Feedback — A specialist has identified a specific preserved visual response that can be explained and explored safely during an appointment. [Specialist clinical practice; direct treatment evidence is limited]
• Graded Visual Tasks Linked to Daily Life — An assessed, low-risk visual task is possible and can be adjusted toward a specific reading, locating or everyday goal. [Clinical rehabilitation adaptation; no established universal exercise dose]
• Supported Visual Choice Without Waiting for Certainty — A clinician-selected matching or pointing task may reveal usable information even when the person cannot confidently describe what they see. [Specialist clinical example; experimental therapeutic use rather than a validated home test]
• Photophobia: An Agreed Light and Protection Plan — Light sensitivity limits activities and specialist assessment supports considering a tolerable, individualized change alongside treatment of relevant causes. [Specialist clinical guidance; FND-specific exposure evidence is limited and there is no universal schedule]
• Treatment of Coexisting Eye, Migraine and Neurological Conditions — Functional visual symptoms coexist with a treatable eye, headache or neurological problem, or a changed presentation needs reassessment. [Clinical assessment and condition-specific care; improvement does not identify a single mechanism]
• Hypnotherapy and Transparent Therapeutic Suggestion — A person wishes to discuss an optional clinician-delivered approach after the diagnosis and uncertain evidence have been explained. [Emerging, very limited visual-specific evidence; not established routine treatment]
• Advanced Visual Feedback and Non-Invasive Brain Stimulation: Specialist Review — A specialist or research team is evaluating an experimental visual-feedback or stimulation approach after discussing uncertainty and alternatives. [Experimental or early clinical-report evidence; no established self-treatment protocol]

Functional speech and voice symptoms

Eleven original entries, eleven detailed pages; see the collection mapping.

• Understanding the Diagnosis and Finding an Easier Starting Point — An assessed speech or voice problem needs a clear explanation, and differences between tasks may help the therapist choose where to begin. [Professional consensus; a useful demonstration does not prove dependable speech in daily life]
• Finding a Comfortable Automatic Voice — Functional loss or strain of voice has been assessed, and a comfortable non-conversational sound may be easier than deliberate speech. [Professional consensus; choice of sound requires voice and respiratory assessment]
• Using Rhythm, Singing or Familiar Sequences — Speech initiation or fluency changes with a familiar sequence, a gentle rhythm or melody, and that cue is comfortable and useful. [Professional consensus; evidence from other speech disorders cannot be assumed to apply to FND]
• Building an Easier Sound Into Words and Conversation — A sound, syllable or word is available with less effort, but carrying it into longer speech remains difficult. [Professional consensus; the progression must follow the person’s response]
• Finding a Helpful Speech Rate and Pattern — Assessed speech blocks, effort, timing or unwanted accent/prosody changes may respond to a different pace or emphasis. [Professional consensus; no single rate or pitch pattern suits every presentation]
• Focusing on the Message and the Listener — Monitoring each sound interrupts an otherwise manageable exchange, and a simple shared purpose may make speaking less effortful. [Professional consensus; adding distraction or a second task is not universally helpful]
• Making Speech More Comfortable: Breath, Posture and Muscle Release — Assessment finds extra jaw, neck, laryngeal or breathing effort during speech, and a tailored adjustment may reduce strain. [Professional consensus and adjacent voice guidance; generic deep breathing is not a prescription]
• Practising the Conversations You Want to Have — A strategy helps in therapy but has not yet become usable in the conversations, calls or everyday exchanges that matter. [Professional consensus; participation goals and practice demands should be individualized]
• Communication Support When Speech Is Difficult or Unavailable — Speech is unreliable, exhausting or unavailable, and another way to express needs, choices and ordinary conversation is needed. [Communication-access guidance; aids can be temporary, intermittent or ongoing]
• Psychologically Informed Support for Communication — Fear of difficult conversations, distress or unhelpful checking adds to the communication burden, and the person wants support with it. [Professional consensus and limited broader dysphonia research; psychological treatment is not a requirement for all patients]
• Coexisting Conditions and Reassessment of Speech or Voice Changes — Hearing, laryngeal, respiratory, neurological or other health issues may add to communication difficulty, or the symptom pattern has changed. [Clinical assessment and coordinated care; benefits depend on the condition identified]

Functional swallowing symptoms and globus

• Positive explanation — When uncertainty about the diagnosis or safe eating is making every meal feel like a test. [Professional consensus; diagnostic explanation and continuing care]
• Comfortable breathing and posture — When assessment identifies bracing, awkward seating or excess effort around a meal. [Professional consensus and general dysphagia guidance; individual positioning required]
• Jaw, neck and laryngeal release — When a clinician identifies excess muscle effort or bracing that contributes to discomfort. [Professional consensus; manual techniques require trained assessment]
• Graded food texture or volume — When the swallowing team has identified a safe starting intake and a reason to practise a specific change. [Professional consensus and dysphagia safety guidance; no universal texture ladder]
• Graded meal-setting practice — When a safe intake is established but pressure, sensory load or unfamiliar settings restrict participation. [Professional consensus; individualized participation planning]
• Reduce repeated checking and dry swallows — When assessment suggests repeated test swallows or throat checking are adding irritation or symptom focus. [Professional consensus; applies only to unnecessary checking, not protective swallowing]
• External focus or distraction — When a clinician finds that excessive conscious monitoring interferes with an otherwise assessed swallowing task. [Professional consensus; external focus does not establish airway safety]
• Address fear and avoidance — When fear or vigilance is restricting eating after safety has been assessed, including after a frightening event. [Professional consensus; preliminary formulation-based evidence, not a universal exposure protocol]
• Treat coexisting conditions — When dryness, pain, dental, reflux, gastrointestinal, neurological or other problems may be adding to symptoms. [Coordinated clinical care; treatment follows the identified condition]
• Discuss gut–brain neuromodulator medication for assessed globus — Selected people with assessed globus for whom a prescriber judges a medication discussion appropriate. [Adjacent globus trial evidence; benefit for functional dysphagia is not established]
• Review unnecessary restrictions — When an existing restriction may no longer be needed, or its burden warrants reassessment. [Clinical and dysphagia guidance; safety and nutritional review before removal]

Functional cough and upper-airway symptoms

• Noticing the Earliest Cough Urge — Notice the first tickle, tightness, breath change, situation or throat-clear urge before the full cough begins. Track briefly enough to find an intervention point, not to monitor the throat all day. [Professional consensus; individual assessment required]
• Using a Sip and Swallow When It Is Safe — For some assessed patterns, take a small sip and complete one comfortable swallow instead of coughing or clearing repeatedly. Do not use this when swallowing safety is uncertain or when the person is choking. [Professional consensus; individual assessment required]
• Choosing One Comfortable Cough Substitute — A small nasal sniff, dry swallow, pursed-lip exhale or another specific response may interrupt the urge. Selection depends on the person’s respiratory, laryngeal and swallowing assessment. [Professional consensus; individual assessment required]
• Finding a Less Effortful Breathing Pattern — Release the jaw and shoulders and use quiet, efficient breathing taught by the clinician. Avoid repeated huge inhalations, which may worsen light-headedness or some breathing patterns. [Professional consensus; individual assessment required]
• Coordinating Gentle Lower-Rib Breathing — When indicated, practise gentle lower-rib movement and unforced exhalation at rest before applying it around triggers. The goal is coordinated breathing, not maximal breath depth. [Professional consensus; individual assessment required]
• Easing Repeated Throat Clearing — Substitute one sip, swallow or gentle breath when safe, and address dryness or irritation. Repeated throat clearing can itself maintain irritation, but a new airway warning should never be suppressed without assessment. [Professional consensus; individual assessment required]
• Returning to Activities With Graded Trigger Practice — After medical causes and safety are reviewed, practise the selected response with a mild version of a familiar trigger, then progress slowly toward real situations. Do not provoke severe respiratory symptoms at home. [Professional consensus; individual assessment required]
• Making Daily Life Kinder to Your Throat — Follow individualized advice about fluids, humidity, voice use and irritants. Generic rules may not suit fluid restrictions, reflux or occupational exposure. [Professional consensus; individual assessment required]
• Working With Attention, Worry and the Cough Urge — Where threat, vigilance or stress amplifies the urge, treatment may include attention shifting, paced exposure or psychological care. This does not imply that the cough is fabricated. [Professional consensus; individual assessment required]
• Keeping Other Causes and Conditions in the Care Plan — Asthma, eosinophilic disease, reflux, rhinitis, infection, medication effects and structural or neurological laryngeal problems need appropriate treatment. [Professional consensus; individual assessment required]

Functional Cognitive Disorder

• FCD background → Understanding Memory and Thinking Difficulties in FCD — Connects the assessed cognitive pattern with an individual support and review plan. [Foundation for recovery; educational guidance, not a memory-training exercise]
• FCD background → Taking a Break From Repeated Memory Tests — When repeatedly testing your own recall to check whether memory works has become distressing or disruptive; keep necessary checks and reminders. [Clinical guidance; individual technique efficacy not established]
• FCD background → Finding Reassurance That Still Helps — When asking someone else for the same assurance briefly settles a worry that soon returns; distinguish this from forgetting or not understanding the answer. [Clinical guidance; individual technique efficacy not established]
• FCD background → Giving One Task Your Attention — Reduce competing input to support attention, encoding and working memory. [Clinical guidance; individual technique efficacy not established]
• FCD background → Comparing What You Expect With What Happens — When a strongly negative prediction makes a modest, safe task feel impossible. [Clinical guidance; individual technique efficacy not established]
• FCD background → Keeping a Small Record of What Helped — When difficulties dominate recall and useful strategies or moments of participation are easily lost. [Clinical guidance; individual technique efficacy not established]
• FCD background → Returning to Reading, Conversation and Other Valued Tasks — When cognitive symptoms have interrupted an activity you want to resume or adapt. [Clinical guidance; individual technique efficacy not established]
• FCD background → Building a Thinking and Memory System You Can Actually Use — External cognitive supports for encoding, future intentions, retrieval, recognition cues and task sequences. [Clinical guidance; individual technique efficacy not established]
• FCD background → Making the Day Easier With Routines and Pacing — Reduce switching and sequencing demands; pace tasks to capacity and delayed cost. [Clinical guidance; individual technique efficacy not established]
• FCD background → Keeping Other Contributors in the Care Plan — Assess and treat independent or coexisting contributors without automatically calling them FCD. [Clinical guidance; individual technique efficacy not established]
• FCD background → Considering an Online ACT Group — When a person wants therapist-led help with symptom interference and valued activities, and an appropriate group is available. [Emerging evidence; randomized feasibility study, not proof of efficacy]
• FCD background → Considering FCD-Specific Digital Self-Help — When a person prefers flexible self-help and can access a suitable programme with an agreed clinical follow-up plan. [Emerging evidence; uncontrolled feasibility study, not proof of efficacy]
• FCD background → Planning Individual Cognitive Rehabilitation — When needs are complex, basic adaptations are insufficient or a person needs support applying strategies in daily life. [Clinical rehabilitation guidance and early intervention development; efficacy uncertain]

Persistent postural-perceptual dizziness

• Building a Vestibular Rehabilitation Plan That Fits You — When ongoing dizziness affects several parts of daily life and exercises need to match your assessed pattern. [Clinical rehabilitation with emerging PPPD evidence; no universal programme]
• Practising Head and Body Movement in Manageable Steps — When familiar, assessed movements such as turning towards a person or bending during a task reliably bring on dizziness. [Clinical adaptation within rehabilitation; standalone efficacy uncertain]
• Making Sitting, Standing and Walking More Manageable — When upright activity worsens an established PPPD pattern, with faintness and other causes assessed separately. [Individualized rehabilitation guidance; component efficacy uncertain]
• Making Busy Visual Settings More Manageable — When scrolling, passing traffic, shelves or moving crowds worsen assessed visually induced dizziness. [Clinical adaptation with limited PPPD-specific evidence]
• Using Gaze-Stability Exercises Only When They Fit — When assessment identifies a problem keeping vision clear during head movement that a gaze exercise is intended to address. [Adjacent vestibular-hypofunction guideline; not mandatory PPPD treatment]
• Practising Balance and Walking With Appropriate Support — When assessed unsteadiness affects standing, turning or walking and practice needs to account for fall risk. [Clinical rehabilitation; adjacent balance evidence and limited PPPD component evidence]
• Returning to Places and Activities That Matter — When dizziness has made a valued outing difficult and a practical, supported version could be explored. [Individualized participation planning within rehabilitation; standalone efficacy uncertain]
• Working With Worry and Attention During Vestibular Rehabilitation — When symptom-related worry, constant monitoring or an assessed avoidance pattern makes rehabilitation harder and the person wants help with it. [Emerging CBT-informed package evidence; not proof of psychological causation]
• Keeping Other Causes of Dizziness in the Care Plan — When migraine, positional vertigo, faintness, medicines or another condition may coexist with PPPD or change the treatment plan. [Diagnostic and clinical care guidance; not an isolated PPPD treatment]
• Considering Supervised Visual-Motion or Virtual-Reality Practice — When a specialist proposes technology to tailor visual practice and simpler options have been considered. [Emerging small-study evidence; optional specialist-selected adjunct]
• Discussing Experimental Stimulation With a Specialist — When a qualified team proposes a stimulation device or research study and you want to understand its limits and alternatives. [Experimental or emerging evidence; no established self-treatment protocol]
• Discussing an SSRI or SNRI With Your Prescriber — When medication is being considered for persistent dizziness or a coexisting condition and the benefits, risks and follow-up need to be clear. [Used in clinical practice; PPPD-specific placebo-controlled evidence uncertain]
• Making a Plan for Flares and Changing Dizziness — When stronger periods of familiar dizziness disrupt daily life and you need a clear plan for support, activity and reassessment. [Clinical self-management and care planning; standalone efficacy untested]

Functional facial symptoms

• Understanding What Your Face Is Doing — When a clinician has diagnosed a functional facial symptom and you need to understand what the finding means for care. [Specialist clinical guidance; explanation is a foundation for care]
• Building a Rehabilitation Plan Around Daily Life — When facial symptoms affect several daily activities and you need help choosing a practical starting point. [Broader motor rehabilitation evidence; facial-specific effectiveness uncertain]
• Making a Plan for Familiar Facial Episodes — When an assessed facial symptom comes in episodes and it would help to decide in advance what you and others will do. [One facial case within a case series; individualized care planning]
• Finding Easier Movement During Conversation — When a therapist has noticed that a facial movement is easier during an ordinary activity than during deliberate testing. [Clinical motor-retraining guidance; facial component efficacy untested]
• Choosing a Facial or Mouth Task With Your Therapist — When assessment has identified one movement or everyday function that could be practised safely. [Individualized clinical guidance; no standard facial exercise prescription]
• Planning Gentle Practice Around an Assessed Trigger — When an assessed movement or lighting situation reliably brings on familiar symptoms and a clinician considers planned practice appropriate. [Specialist guidance; facial exposure efficacy uncertain]
• Making Your Face, Jaw and Neck More Comfortable — When pulling or an effort to correct it leaves your jaw, face or neck uncomfortable. [Clinical comfort guidance; direct facial-treatment evidence limited]
• Protecting Eating, Vision and Communication — When facial symptoms interfere with mouth closure, eating, communication or usable vision. [Clinical safety and access support; recovery does not require removing aids]
• Keeping Other Causes and Conditions in the Care Plan — When pain, eye symptoms, jaw problems, medicines or another condition may be contributing alongside FND. [Clinical differential assessment and coordinated care]
• Discussing Botulinum Toxin With a Specialist — When a specialist proposes an injection for a specific facial pattern or a coexisting movement disorder. [Uncertain selected use; evidence does not support routine injection for functional facial symptoms]

Functional paralysis

Seven original entries, expanded one-to-one. Collection overview.

• Finding a Movement You Can Start With — When a limb will not move on request, a therapist looks for a safe movement that is available within another action. [Clinical motor-rehabilitation consensus; isolated technique efficacy uncertain]
• Practising a Useful Task With Attention on Its Purpose — When some movement is available, practise an everyday action with attention on its result rather than repeatedly checking the limb. [Clinical and occupational-therapy consensus; severe-paralysis-specific component evidence limited]
• Using Equipment and Protecting Your Body — When severe movement loss makes transfers, positioning or daily access difficult, choose equipment and a body-care plan that meet current needs. [Clinical safety and access guidance; equipment is not a proven movement-restoration treatment]
• Choosing a Manageable Amount of Practice — When practice or daily care leaves too little capacity for the rest of the day, adjust the amount and review delayed effects before increasing it. [Individualized rehabilitation consensus; no universal progression schedule]
• Getting the Team Working From One Plan — When movement, personal care, symptoms and practical support involve several services, agree who does what and how the plans fit together. [Multidisciplinary clinical consensus; broader programme evidence with important limits]
• Making a Plan for Familiar Paralysis Episodes — When assessed limb immobility comes in episodes, agree safe positioning, communication, optional movement cues and a route back to the interrupted activity. [Individualized clinical planning; an episode-stopping effect is unproven]
• Keeping Life Open While Movement Is Limited — When paralysis continues, protect everyday choices, relationships, transport and practical support while keeping future treatment options open. [Rehabilitation and occupational-therapy consensus; participation is a valid outcome]

Body protection: Positioning, pressure relief, skin and joint care are retained within equipment and body care, not counted as an eighth original entry.

Functional drop attacks

Seven original entries expanded one-to-one. Collection overview.

• Agreeing What to Do After a Fall — When a sudden fall happens, a short plan helps you and others check safety, recognize injury and get the right help. [Clinical safety guidance; injury response is supportive care]
• Making Everyday Places Safer — When attacks can arrive without warning, change the surroundings and the way an activity is done to reduce avoidable harm. [Clinical safety and occupational-therapy guidance; direct attack prevention unproven]
• Choosing Support for Getting Around — When walking or standing leaves you vulnerable to sudden falls, choose assessed aids, seating, assistance and routes that support daily access. [Individualized clinical and access guidance; no aid guarantees prevention]
• Looking for a Warning Only If There Is One — When a repeatable change genuinely comes before an attack, agree one safe response; if there is no warning, use planning that does not depend on it. [Specialist guidance and emerging model; preventive effect uncertain]
• Getting Up Safely After an Uninjured Event — After a familiar event without injury, use a previously assessed way to rise or obtain help, without repeated standing tests. [Clinical falls-safety guidance; not an attack-stopping treatment]
• Returning to Activities With the Right Support — When fear, symptoms or practical barriers have narrowed daily life, choose a meaningful activity and an adequately supported first step. [Individualized rehabilitation guidance; drop-attack-specific effectiveness uncertain]
• Keeping Other Conditions in the Care Plan — When more than one symptom or event contributes to falls, identify the patterns and give each the assessment and treatment it needs. [Clinical assessment and coordinated care; treatment response does not establish cause]

Alphabetical technique index

A Prescriber-Led Medication Discussion for Assessed Globus — Swallowing/globus: Selected people with assessed globus for whom a prescriber judges a medication discussion appropriate. [Adjacent globus trial evidence; benefit for functional dysphagia is not established]

Advanced Visual Feedback and Non-Invasive Brain Stimulation: Specialist Review — Functional visual symptoms. A specialist or research team is evaluating an experimental visual-feedback or stimulation approach after discussing uncertainty and alternatives. [Experimental or early clinical-report evidence; no established self-treatment protocol]

Attention redirection or external-focus practice — Limb weakness; paralysis; tremor; jerks; dystonia; gait; sensory symptoms; speech/voice; facial symptoms. C

Automatic and task-oriented movement retraining — Limb weakness; paralysis; gait; dystonia. C

Available-movement entry point for severe paralysis — When a limb will not move on request, a therapist looks for a safe movement that is available within another action. [Clinical motor-rehabilitation consensus; isolated technique efficacy uncertain]

Backward, sideways and direction-change walking — Functional gait disorder; functional ankle weakness when the alternative direction is assessed as safe and useful. [Clinical consensus; not helpful or safe for everyone]

Botulinum toxin discussion after specialist phenotype review — Additional specialist treatment review. Selected functional dystonia and functional facial symptoms; routine use is not supported. [A small functional-dystonia pilot randomized trial found no added benefit over placebo before cognitive behavioural therapy; selected use remains uncertain]

Breathing, posture and muscle-relaxation exercises — Speech/voice; tremor; facial symptoms. C

Brief pattern and context mapping — Functional tics: If useful, note a few examples of what happened before, during and after symptoms, including discomfort, urges, surroundings and other people’s responses. Stop if tracking makes life revolve around symptoms; no warning or trigger has to be found. [Assessment and treatment-planning component; clinical consensus]

FCD background → Building a Thinking and Memory System You Can Actually Use — External cognitive supports for encoding, future intentions, retrieval, recognition cues and task sequences. [Clinical guidance; individual technique efficacy not established]

Building a Rehabilitation Plan Around Daily Life — Functional facial symptoms: When facial symptoms affect several daily activities and you need help choosing a practical starting point. [Broader motor rehabilitation evidence; facial-specific effectiveness uncertain]

Building a Vestibular Rehabilitation Plan That Fits You — PPPD: When ongoing dizziness affects several parts of daily life and exercises need to match your assessed pattern. [Clinical rehabilitation with emerging PPPD evidence; no universal programme]

Building an Easier Sound Into Words and Conversation — Functional speech and voice symptoms. A sound, syllable or word is available with less effort, but carrying it into longer speech remains difficult. [Professional consensus; the progression must follow the person’s response]

Choosing a Facial or Mouth Task With Your Therapist — Functional facial symptoms: When assessment has identified one movement or everyday function that could be practised safely. [Individualized clinical guidance; no standard facial exercise prescription]

Choosing One Comfortable Cough Substitute — A small nasal sniff, dry swallow, pursed-lip exhale or another specific response may interrupt the urge. Selection depends on the person’s respiratory, laryngeal and swallowing assessment. [Professional consensus; individual assessment required]

Clinician-Taught Breathing Control — Functional seizures. Seek respiratory assessment and comfortable, supervised practice when breathing patterns may be relevant; do not improvise breath-holding or deep-breathing drills. [Emerging evidence; a published randomized-trial protocol is not an efficacy result]

Coexisting Conditions and Reassessment of Speech or Voice Changes — Functional speech and voice symptoms. Hearing, laryngeal, respiratory, neurological or other health issues may add to communication difficulty, or the symptom pattern has changed. [Clinical assessment and coordinated care; benefits depend on the condition identified]

Coexisting Pain, Migraine and Medical Review — Functional sensory symptoms. Burning, pain, spreading numbness or sensory overload may have more than one contributor, or a changed pattern needs reassessment. [Clinical assessment and coordinated-care consensus; treatment follows the condition identified]

Coexisting-Condition and Load Review — Functional seizures. Address a specific untreated condition or practical burden, such as pain, sleep disruption or difficult access to care, even when seizures continue. [Clinical guideline and multidisciplinary care; benefits for another condition do not prove a seizure effect]

Coexisting-condition and medication review — Functional tics: Review a possible primary tic disorder, ADHD, OCD, anxiety, depression, pain, sleep difficulty or other FND when relevant. Medication may treat a coexisting condition; it is not automatically a treatment for the functional symptom mechanism. Change medicines only with the prescriber. [Coordinated care; clinical consensus]

Cold or textured sensory grounding at a familiar warning — Functional seizures; a tolerable sensory variant, without isolated efficacy evidence. [Specialist clinical guidance for grounding; cool-object variants also appear in community reports]

Comfortable Breathing and Supported Positioning for Meals — Swallowing/globus: When assessment identifies bracing, awkward seating or excess effort around a meal. [Professional consensus and general dysphagia guidance; individual positioning required]

Communication Support When Speech Is Difficult or Unavailable — Functional speech and voice symptoms. Speech is unreliable, exhausting or unavailable, and another way to express needs, choices and ordinary conversation is needed. [Communication-access guidance; aids can be temporary, intermittent or ongoing]

FCD background → Comparing What You Expect With What Happens — When a strongly negative prediction makes a modest, safe task feel impossible. [Clinical guidance; individual technique efficacy not established]

Competing movement or absorbing task — Tremor; jerks. C

FCD background → Considering an Online ACT Group — When a person wants therapist-led help with symptom interference and valued activities, and an appropriate group is available. [Emerging evidence; randomized feasibility study, not proof of efficacy]

FCD background → Considering FCD-Specific Digital Self-Help — When a person prefers flexible self-help and can access a suitable programme with an agreed clinical follow-up plan. [Emerging evidence; uncontrolled feasibility study, not proof of efficacy]

Considering Supervised Visual-Motion or Virtual-Reality Practice — PPPD: When a specialist proposes technology to tailor visual practice and simpler options have been considered. [Emerging small-study evidence; optional specialist-selected adjunct]

Continuing accessibility and participation support — Functional paralysis; persistent drop attacks also require access support. [Rehabilitation and occupational-therapy consensus; participation is a valid outcome]

Coordinated multidisciplinary care for severe motor loss — When movement, personal care, symptoms and practical support involve several services, agree who does what and how the plans fit together. [Multidisciplinary clinical consensus; broader programme evidence with important limits]

Coordinating Gentle Lower-Rib Breathing — When indicated, practise gentle lower-rib movement and unforced exhalation at rest before applying it around triggers. The goal is coordinated breathing, not maximal breath depth. [Professional consensus; individual assessment required]

Desensitization for Painful Touch and Hypersensitivity — Functional sensory symptoms. Clothing, washing or another normally non-painful contact hurts or overwhelms the person after relevant causes have been assessed. [Clinical consensus; direct evidence for an isolated FND desensitization protocol is limited]

Desensitization or graded sensory reintroduction — Functional sensory symptoms and dystonia when safe ordinary contact is unusually unpleasant and limits use. [Clinical consensus; direct functional-dystonia component evidence is limited]

Diagnostic Explanation and Continuing Care — Functional seizures. Ask how the diagnosis was established for each event type and leave with a written explanation, a treatment contact and follow-up. [Clinical guideline recommendation; explanation alone is not an established seizure-stopping treatment]

Diagnostic explanation and education as part of treatment — All 17 symptom groups. C

Discussing an SSRI or SNRI With Your Prescriber — PPPD: When medication is being considered for persistent dizziness or a coexisting condition and the benefits, risks and follow-up need to be clear. [Used in clinical practice; PPPD-specific placebo-controlled evidence uncertain]

Discussing Botulinum Toxin With a Specialist — Functional facial symptoms: When a specialist proposes an injection for a specific facial pattern or a coexisting movement disorder. [Uncertain selected use; evidence does not support routine injection for functional facial symptoms]

Discussing Experimental Stimulation With a Specialist — PPPD: When a qualified team proposes a stimulation device or research study and you want to understand its limits and alternatives. [Experimental or emerging evidence; no established self-treatment protocol]

Easing Repeated Throat Clearing — Substitute one sip, swallow or gentle breath when safe, and address dryness or irritation. Repeated throat clearing can itself maintain irritation, but a new airway warning should never be suppressed without assessment. [Professional consensus; individual assessment required]

Electrical muscle stimulation, functional electrical stimulation or TENS as an adjunct — Weakness, dystonia and sensory symptoms when a qualified clinician identifies a specific sensory, motor or pain goal. [Emerging and uncertain evidence]

Episode, Flare and Available-Capacity Planning — Additional flare-planning guidance. Functional sensory symptoms. 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]

Exaggerated movement and marching — Functional gait disorder when a deliberately different step improves clearance or organization and can be shaped toward ordinary gait. [Clinical consensus; direct component evidence is limited]

External Attention and Task Focus — Functional sensory symptoms. Repeatedly checking a familiar altered sensation disrupts an otherwise safe activity, and a simple external cue is tolerable. [Clinical consensus principle; no isolated sensory-symptom efficacy claim]

Episode plan for familiar paralysis — When assessed limb immobility comes in episodes, agree safe positioning, communication, optional movement cues and a route back to the interrupted activity. [Individualized clinical planning; an episode-stopping effect is unproven]

External focus and purposeful dual-task walking — Functional gait disorder when an external destination or simple second task improves rather than compromises walking safety. [Clinical and occupational-therapy consensus]

Fall-injury response and reassessment plan — When a sudden fall happens, a short plan helps you and others check safety, recognize injury and get the right help. [Clinical safety guidance; injury response is supportive care]

Family, school and workplace response planning — Functional tics: Agree who should know, what help you want and how others should respond. Options include a private break space, alternative presentations and a simple explanation of involuntary words. Avoid punishment, shame or demands to suppress symptoms to earn access. [Support and accommodation planning]

Finding a Comfortable Automatic Voice — Functional speech and voice symptoms. Functional loss or strain of voice has been assessed, and a comfortable non-conversational sound may be easier than deliberate speech. [Professional consensus; choice of sound requires voice and respiratory assessment]

Finding a Helpful Speech Rate and Pattern — Functional speech and voice symptoms. Assessed speech blocks, effort, timing or unwanted accent/prosody changes may respond to a different pace or emphasis. [Professional consensus; no single rate or pitch pattern suits every presentation]

Finding a Less Effortful Breathing Pattern — Release the jaw and shoulders and use quiet, efficient breathing taught by the clinician. Avoid repeated huge inhalations, which may worsen light-headedness or some breathing patterns. [Professional consensus; individual assessment required]

FCD background → Finding Reassurance That Still Helps — When asking someone else for the same assurance briefly settles a worry that soon returns; distinguish this from forgetting or not understanding the answer. [Clinical guidance; individual technique efficacy not established]

Finding Easier Movement During Conversation — Functional facial symptoms: When a therapist has noticed that a facial movement is easier during an ordinary activity than during deliberate testing. [Clinical motor-retraining guidance; facial component efficacy untested]

Fixed visual or sensory anchor at a familiar warning — Functional seizures with a usable warning and tolerable cue. [Specialist clinical guidance; no isolated efficacy evidence]

Focusing on the Message and the Listener — Functional speech and voice symptoms. Monitoring each sound interrupts an otherwise manageable exchange, and a simple shared purpose may make speaking less effortful. [Professional consensus; adding distraction or a second task is not universally helpful]

Foot sliding or “skating” progression — Functional gait disorder and functional ankle weakness when surface contact permits movement that deliberate foot lifting does not. [Clinical consensus; direct component evidence is limited]

FCD background → Giving One Task Your Attention — Reduce competing input to support attention, encoding and working memory. [Clinical guidance; individual technique efficacy not established]

Graded activity and reconditioning — Weakness; paralysis; gait; PPPD; mixed motor symptoms. [Clinical consensus]

Graded community walking and environmental complexity — Functional gait disorder when clinic gains do not yet transfer to meaningful real-world routes. [Clinical and occupational-therapy consensus; supported only as part of broader rehabilitation programmes]

Graded exposure to avoided tasks or triggers — Dystonia; sensory symptoms; visual symptoms; PPPD; selected functional facial symptoms. C/E

Graded return to avoided activity with fall support — When fear, symptoms or practical barriers have narrowed daily life, choose a meaningful activity and an adequately supported first step. [Individualized rehabilitation guidance; drop-attack-specific effectiveness uncertain]

Graded Return to Clothing, Footwear and Everyday Contact — Functional sensory symptoms. A particular necessary contact is avoided or shortened because it is unpleasant, even though a smaller version may be manageable. [Clinical consensus; use an individualized goal and retain necessary accommodations]

Graded Sensory Input for Reduced or Altered Sensation — Functional sensory symptoms. Contact feels faint, absent or unfamiliar, and a safe, tolerable input can be paired with a simple task. [Clinical consensus; the particular practice sequence is an educational adaptation, not a tested standalone treatment]

Graded Visual Tasks Linked to Daily Life — Functional visual symptoms. An assessed, low-risk visual task is possible and can be adjusted toward a specific reading, locating or everyday goal. [Clinical rehabilitation adaptation; no established universal exercise dose]

Graded weight-bearing and functional use — Functional dystonia when a hand or foot avoids contact or can accept some supported load but not yet participate fully in a task. [Clinical consensus]

Hypnotherapy and Transparent Therapeutic Suggestion — Functional visual symptoms. A person wishes to discuss an optional clinician-delivered approach after the diagnosis and uncertain evidence have been explained. [Emerging, very limited visual-specific evidence; not established routine treatment]

Individualized Episode Safety Plan — Functional seizures. Prepare the surroundings and response for shaking, still or unresponsive events, especially when there is no time to act on a warning. [Clinical safety guidance; not a method for forcing an episode to stop]

Individualized multidisciplinary treatment for functional dystonia — Additional coordinated-care guidance. Functional dystonia interacting with pain, daily activities, psychological needs when relevant, equipment, work or coexisting conditions. [Small case-series, pilot-trial and programme-level evidence plus multidisciplinary clinical consensus; no single package fits everyone]

Individualized rehabilitation and relapse planning for functional gait disorder — Functional gait disability requiring selected movement, equipment, participation and coexisting-condition plans. [Functional-gait-specific and mixed functional-motor programme evidence; no single component is established as the active ingredient]

Individually formulated behavioral or psychological treatment — Functional tics: A clinician familiar with both tics and FND can discuss an approach suited to your symptoms and priorities. I-CBiT combines several methods and has early case-series evidence. Its exercises, including exposure and response prevention, need individual assessment and consent; this page is not a home suppression programme. [Emerging evidence; uncontrolled series of eight young people]

FCD background → Keeping a Small Record of What Helped — When difficulties dominate recall and useful strategies or moments of participation are easily lost. [Clinical guidance; individual technique efficacy not established]

Keeping Other Causes and Conditions in the Care Plan — Asthma, eosinophilic disease, reflux, rhinitis, infection, medication effects and structural or neurological laryngeal problems need appropriate treatment. [Professional consensus; individual assessment required]

Keeping Other Causes and Conditions in the Care Plan — Functional facial symptoms: When pain, eye symptoms, jaw problems, medicines or another condition may be contributing alongside FND. [Clinical differential assessment and coordinated care]

Keeping Other Causes of Dizziness in the Care Plan — PPPD: When migraine, positional vertigo, faintness, medicines or another condition may coexist with PPPD or change the treatment plan. [Diagnostic and clinical care guidance; not an isolated PPPD treatment]

FCD background → Keeping Other Contributors in the Care Plan — Assess and treat independent or coexisting contributors without automatically calling them FCD. [Clinical guidance; individual technique efficacy not established]

Making a Plan for Familiar Facial Episodes — Functional facial symptoms: When an assessed facial symptom comes in episodes and it would help to decide in advance what you and others will do. [One facial case within a case series; individualized care planning]

Making a Plan for Flares and Changing Dizziness — PPPD: When stronger periods of familiar dizziness disrupt daily life and you need a clear plan for support, activity and reassessment. [Clinical self-management and care planning; standalone efficacy untested]

Making Busy Visual Settings More Manageable — PPPD: When scrolling, passing traffic, shelves or moving crowds worsen assessed visually induced dizziness. [Clinical adaptation with limited PPPD-specific evidence]

Making Daily Life Kinder to Your Throat — Follow individualized advice about fluids, humidity, voice use and irritants. Generic rules may not suit fluid restrictions, reflux or occupational exposure. [Professional consensus; individual assessment required]

Making Meals More Manageable in Different Settings — Swallowing/globus: When a safe intake is established but pressure, sensory load or unfamiliar settings restrict participation. [Professional consensus; individualized participation planning]

Making Sitting, Standing and Walking More Manageable — PPPD: When upright activity worsens an established PPPD pattern, with faintness and other causes assessed separately. [Individualized rehabilitation guidance; component efficacy uncertain]

Making Speech More Comfortable: Breath, Posture and Muscle Release — Functional speech and voice symptoms. Assessment finds extra jaw, neck, laryngeal or breathing effort during speech, and a tailored adjustment may reduce strain. [Professional consensus and adjacent voice guidance; generic deep breathing is not a prescription]

FCD background → Making the Day Easier With Routines and Pacing — Reduce switching and sequencing demands; pace tasks to capacity and delayed cost. [Clinical guidance; individual technique efficacy not established]

Making Your Face, Jaw and Neck More Comfortable — Functional facial symptoms: When pulling or an effort to correct it leaves your jaw, face or neck uncomfortable. [Clinical comfort guidance; direct facial-treatment evidence limited]

Meaningful functional-task practice — Weakness; severe paralysis; tremor; jerks; dystonia; gait; sensory symptoms; speech/voice; facial symptoms. [Clinical consensus; application differs by presentation]

Mirror or visual feedback for functional dystonia — Weakness, tremor, dystonia, sensory symptoms and functional visual symptoms when selected visual information supports a task without increasing checking. [Clinical consensus; direct functional-dystonia component evidence is limited]

Mirror or visual feedback for functional gait disorder — Functional gait disorder when one selected visual reference improves a task without increasing dizziness, visual overload or self-monitoring. [Clinical consensus; direct component evidence is limited]

Mobility aids, guarding and fall planning for functional gait disorder — Functional gait disorder when buckling, swaying, sudden gait loss, fatigue or injury risk requires fitted equipment and a setting-specific plan. [Clinical consensus; falls assessment is supported by observational evidence]

Mobility, seating and transfer-equipment review — Functional paralysis; functional drop attacks. Equipment and assistance are chosen for the assessed presentation and current access needs. [Clinical safety and access guidance; no guarantee of attack prevention]

Mobility-aid, orthosis and equipment review — Weakness, gait and dystonia when equipment has a defined safety, protection or access goal and a review plan. [Clinical consensus]

Motor and vocal safety and communication planning — Functional tics: Plan safer handling of hot or sharp objects, seating and other tasks affected by movements. For vocal interruptions, agree how to finish a message: time, a pause, typing or writing may help. Accommodations protect access even when symptoms continue. [Safety and access planning; not a separately proven treatment]

Music, counting or another external rhythm for gait — Gait, tremor and speech/voice; the linked page concerns accessible gait timing cues. [Clinical consensus; no functional-gait trial isolates auditory cueing]

Neck, jaw and laryngeal relaxation — speech/voice. C

Noticing Briefly Better Vision Without Repeated Testing — Functional visual symptoms. Occasional useful visual moments occur naturally and can help identify a workable task or setting without increasing checking. [Specialist clinical guidance; no isolated efficacy evidence]

Noticing examples of briefly better function — Visual symptoms; movement symptoms. C

Noticing the Earliest Cough Urge — Notice the first tickle, tightness, breath change, situation or throat-clear urge before the full cough begins. Track briefly enough to find an intervention point, not to monitor the throat all day. [Professional consensus; individual assessment required]

Orthoptist-Guided Visual Feedback — Functional visual symptoms. A specialist has identified a specific preserved visual response that can be explained and explored safely during an appointment. [Specialist clinical practice; direct treatment evidence is limited]

Pain, fatigue, sleep, migraine, mental-health and other comorbidity treatment — Potentially all symptom groups, selected individually. C

Pain, skin, joint-range and contracture management — Functional dystonia when an identified secondary complication has become a separate barrier. [Clinical consensus; management must follow the identified complication]

Pairing Sensation With Meaningful Movement — Functional sensory symptoms. An altered-feeling hand or foot is difficult to use, but a supported, useful task is possible. [Clinical and occupational-therapy consensus; programme principles do not prove sensory recovery]

Photophobia: An Agreed Light and Protection Plan — Functional visual symptoms. Light sensitivity limits activities and specialist assessment supports considering a tolerable, individualized change alongside treatment of relevant causes. [Specialist clinical guidance; FND-specific exposure evidence is limited and there is no universal schedule]

FCD background → Planning Individual Cognitive Rehabilitation — When needs are complex, basic adaptations are insufficient or a person needs support applying strategies in daily life. [Clinical rehabilitation guidance and early intervention development; efficacy uncertain]

Planning Gentle Practice Around an Assessed Trigger — Functional facial symptoms: When an assessed movement or lighting situation reliably brings on familiar symptoms and a clinician considers planned practice appropriate. [Specialist guidance; facial exposure efficacy uncertain]

Position and gravity change — Functional dystonia when movement is more available lying, sitting, leaning or with the limb supported. [Clinical consensus]

Positioning, pressure relief, skin and contracture prevention — Functional paralysis: supportive care within the equipment page. [Clinical safety guidance; not a separate original intervention]

Positive explanation and a shared plan — Functional tics: Ask the clinician to explain what supports the diagnosis, what remains uncertain and what help is available. Agree on one or two goals that matter to you, such as finishing a conversation or getting through a meal more comfortably. [Clinical consensus]

Positive Explanation of Preserved Vision and Follow-Up — Functional visual symptoms. The person has an assessed functional visual-loss pattern and needs to understand the positive findings, remaining uncertainty and continuing-care plan. [Specialist clinical guidance; explanation is not a guaranteed vision-restoring treatment]

Posture and alignment retraining — Tremor; dystonia; weakness; gait. C

Practising Balance and Walking With Appropriate Support — PPPD: When assessed unsteadiness affects standing, turning or walking and practice needs to account for fall risk. [Clinical rehabilitation; adjacent balance evidence and limited PPPD component evidence]

Practising Head and Body Movement in Manageable Steps — PPPD: When familiar, assessed movements such as turning towards a person or bending during a task reliably bring on dizziness. [Clinical adaptation within rehabilitation; standalone efficacy uncertain]

Practising the Conversations You Want to Have — Functional speech and voice symptoms. A strategy helps in therapy but has not yet become usable in the conversations, calls or everyday exchanges that matter. [Professional consensus; participation goals and practice demands should be individualized]

Practising With Assessed Food Textures and Amounts — Swallowing/globus: When the swallowing team has identified a safe starting intake and a reason to practise a specific change. [Professional consensus and dysphagia safety guidance; no universal texture ladder]

Prescriber-Led Medication Review — Functional seizures. Clarify the purpose of every regular and rescue medicine and arrange supervised changes only when indicated, including separate treatment for coexisting epilepsy. [Clinical guideline recommendation; no unsupervised withdrawal]

Proportionate fall-hazard and activity review — When attacks can arrive without warning, change the surroundings and the way an activity is done to reduce avoidable harm. [Clinical safety and occupational-therapy guidance; direct attack prevention unproven]

Protecting Eating, Vision and Communication — Functional facial symptoms: When facial symptoms interfere with mouth closure, eating, communication or usable vision. [Clinical safety and access support; recovery does not require removing aids]

Psychologically Informed Support for Communication — Functional speech and voice symptoms. Fear of difficult conversations, distress or unhelpful checking adds to the communication burden, and the person wants support with it. [Professional consensus and limited broader dysphonia research; psychological treatment is not a requirement for all patients]

ReACT for Children and Adolescents — Additional age-specific treatment page. Functional seizures. Consider a clinician-delivered paediatric programme with an individualized response and family plan; its evidence does not establish the same approach for adults. [Emerging paediatric programme evidence; do not generalize directly to adults]

Recovery, Cluster and Flare Planning — Additional recovery-planning guidance. Functional seizures. Separate the visible event from prolonged recovery or surrounding symptoms and plan safe transfers, communication and reassessment for a changed pattern. [Individualized clinical care; distinguish familiar recovery from a new medical problem]

Reducing Extra Jaw, Neck and Throat Effort — Swallowing/globus: When a clinician identifies excess muscle effort or bracing that contributes to discomfort. [Professional consensus; manual techniques require trained assessment]

Relapse and self-management plan — All 17 symptom groups. C

Responsive rehabilitation dose planning from current capacity — When practice or daily care leaves too little capacity for the rest of the day, adjust the amount and review delayed effects before increasing it. [Individualized rehabilitation consensus; no universal progression schedule]

Returning to Activities With Graded Trigger Practice — After medical causes and safety are reviewed, practise the selected response with a mild version of a familiar trigger, then progress slowly toward real situations. Do not provoke severe respiratory symptoms at home. [Professional consensus; individual assessment required]

Returning to Places and Activities That Matter — PPPD: When dizziness has made a valued outing difficult and a practical, supported version could be explored. [Individualized participation planning within rehabilitation; standalone efficacy uncertain]

FCD background → Returning to Reading, Conversation and Other Valued Tasks — When cognitive symptoms have interrupted an activity you want to resume or adapt. [Clinical guidance; individual technique efficacy not established]

Reviewing Diet and Equipment Restrictions Together — Swallowing/globus: When an existing restriction may no longer be needed, or its burden warrants reassessment. [Clinical and dysphagia guidance; safety and nutritional review before removal]

Rhythmic weight shift progressing into steps — Functional gait disorder and limb weakness when supported loading permits the opposite foot to begin a step. [Clinical consensus; direct component evidence is limited]

Safe recovery from the floor after a familiar event — After a familiar event without injury, use a previously assessed way to rise or obtain help, without repeated standing tests. [Clinical falls-safety guidance; not an attack-stopping treatment]

Seizure-Focused Psychological Treatment — Functional seizures. Choose a structured programme around the person’s goals, such as episode coping or returning to activities, with an honest discussion of mixed trial outcomes. [Research-supported programmes with mixed outcomes; individual components are not independently proven]

Sensory discrimination practice — Functional sensory symptoms. C

Sensory Discrimination: Texture, Location and Object Recognition — Functional sensory symptoms. Touch is detectable but difficult to interpret, distinguish or connect with a familiar object. [Clinical rehabilitation adaptation; FND-specific component efficacy is uncertain]

Sensory Grounding and an Attention Anchor — Functional seizures. At a familiar warning with enough awareness, try one tolerable visual or touch cue already practised in safety; skip cues that add sensory overload. [Specialist clinical guidance; individual grounding variants lack isolated efficacy evidence]

Sensory-Profile Assessment and Environmental Adaptation — Functional sensory symptoms. Multiple forms of sensory input interfere with washing, appointments, rest or other activities, and a tailored OT assessment is needed. [Emerging sensory-based OT evidence; uncontrolled cohort outcomes do not establish causation]

Sensory-profile assessment and sensory-based occupational therapy — Functional sensory symptoms. E

Skin, Pressure and Injury Protection — Additional injury-protection guidance. Functional sensory symptoms. Reduced sensation makes heat, cuts, pressure or footwear injury difficult to notice, including during temporary episodes. [Clinical safety adaptation; protection is supportive care rather than a proven sensory-restoration treatment]

Speed and continuous-walking transformation — Functional gait disorder when another assessed pace improves continuity without increasing risk. [Clinical consensus; direct component evidence is limited]

Stairs as a supervised bridge — Functional gait disorder only when formal assessment finds a stair step safer or more automatic than level walking. [Clinical consensus; stairs carry greater mechanical and fall demands]

Stepping Back From Repeated Throat Checking — Swallowing/globus: When assessment suggests repeated test swallows or throat checking are adding irritation or symptom focus. [Professional consensus; applies only to unnecessary checking, not protective swallowing]

Supported positioning and non-forceful release — Functional dystonia when pain, strong bracing or worsening with passive pulling makes a supported starting position most appropriate. [Clinical consensus]

Supported Return to Activities — Functional seizures. Adapt one valued activity for event unpredictability, fatigue and safety, preserving the aids and help that make participation possible. [Clinical and occupational-therapy guidance; programme evidence does not establish a fixed activity dose]

Supported return to routines and valued activity — Functional tics: Choose a manageable way to stay involved in something important, with breaks, help or adaptations as needed. Review effort, pain and recovery cost. Participation does not have to wait until symptoms disappear. [Clinical consensus; individualized rehabilitation principle]

Supported Visual Choice Without Waiting for Certainty — Functional visual symptoms. A clinician-selected matching or pointing task may reveal usable information even when the person cannot confidently describe what they see. [Specialist clinical example; experimental therapeutic use rather than a validated home test]

Supporter Response Rehearsal — Additional supporter-planning guidance. Functional seizures. Talk through the agreed response with chosen supporters between events, including who stays, who helps and when medical escalation is needed. [Clinical guideline and safety guidance; rehearsal is an implementation aid]

Surface-EMG biofeedback — Tremor and dystonia when a selected superficial muscle-activity signal supports a specific movement-learning goal. [Clinical consensus; direct functional-dystonia treatment evidence is very limited]

FCD background → Taking a Break From Repeated Memory Tests — When repeatedly testing your own recall to check whether memory works has become distressing or disruptive; keep necessary checks and reminders. [Clinical guidance; individual technique efficacy not established]

TENS and Electrical Stimulation: Specialist Review and Safety — Functional sensory symptoms. A qualified clinician is considering electrical input for a specific pain or rehabilitation goal and needs to establish whether it is suitable. [Emerging and uncertain FND evidence; safety review is essential]

Tic-attack, cluster and flare planning — Functional tics: For familiar intense bouts, agree how to reduce immediate hazards, offer calm support, allow recovery and recognize a change needing assessment. A prolonged bout is not automatically a functional seizure. A plan should work even when there is no warning. [Safety and relapse planning; clinical consensus]

Treadmill and body-weight-supported walking — Limb weakness and functional gait disorder when equipment supplies a useful stepping condition or required fall protection. [Clinical consensus; direct device-specific evidence in functional gait disorder is limited]

Treating Other Conditions That Make Swallowing Harder — Swallowing/globus: When dryness, pain, dental, reflux, gastrointestinal, neurological or other problems may be adding to symptoms. [Coordinated clinical care; treatment follows the identified condition]

Treatment of Coexisting Eye, Migraine and Neurological Conditions — Functional visual symptoms. Functional visual symptoms coexist with a treatable eye, headache or neurological problem, or a changed presentation needs reassessment. [Clinical assessment and condition-specific care; improvement does not identify a single mechanism]

Treatment of overlapping fall and event phenotypes — When more than one symptom or event contributes to falls, identify the patterns and give each the assessment and treatment it needs. [Clinical assessment and coordinated care; treatment response does not establish cause]

Trigger, warning-sign and pattern mapping — Functional seizures; jerks; mixed episodic symptoms. C

FCD background → Understanding Memory and Thinking Difficulties in FCD — Connects the assessed cognitive pattern with an individual support and review plan. [Foundation for recovery; educational guidance, not a memory-training exercise]

Understanding the Diagnosis and Finding an Easier Starting Point — Functional speech and voice symptoms. An assessed speech or voice problem needs a clear explanation, and differences between tasks may help the therapist choose where to begin. [Professional consensus; a useful demonstration does not prove dependable speech in daily life]

Understanding What Your Face Is Doing — Functional facial symptoms: When a clinician has diagnosed a functional facial symptom and you need to understand what the finding means for care. [Specialist clinical guidance; explanation is a foundation for care]

Understanding Your Swallowing Assessment and Plan — Swallowing/globus: When uncertainty about the diagnosis or safe eating is making every meal feel like a test. [Professional consensus; diagnostic explanation and continuing care]

Using a Gentle External Focus During Assessed Practice — Swallowing/globus: When a clinician finds that excessive conscious monitoring interferes with an otherwise assessed swallowing task. [Professional consensus; external focus does not establish airway safety]

Using a Sip and Swallow When It Is Safe — For some assessed patterns, take a small sip and complete one comfortable swallow instead of coughing or clearing repeatedly. Do not use this when swallowing safety is uncertain or when the person is choking. [Professional consensus; individual assessment required]

Using Gaze-Stability Exercises Only When They Fit — PPPD: When assessment identifies a problem keeping vision clear during head movement that a gaze exercise is intended to address. [Adjacent vestibular-hypofunction guideline; not mandatory PPPD treatment]

Using Rhythm, Singing or Familiar Sequences — Functional speech and voice symptoms. Speech initiation or fluency changes with a familiar sequence, a gentle rhythm or melody, and that cue is comfortable and useful. [Professional consensus; evidence from other speech disorders cannot be assumed to apply to FND]

Visual and Mirror Feedback for Altered Body Sensation — Functional sensory symptoms. Watching an affected area helps locate it or perform a safe task without increasing visual discomfort or disconnection. [Clinical rehabilitation adaptation; direct FND sensory-specific mirror evidence is uncertain]

Voluntary tremor retrainment by changing rhythm, amplitude and speed — Functional tremor. [Emerging evidence from a small proof-of-concept study; supported by clinical consensus]

Warning and Pattern Mapping — Functional seizures. Use a brief, low-burden record to find a usable early cue or recovery need; a trigger or remembered warning may never be identifiable. [Specialist clinical guidance; no requirement to find a trigger]

Warning recognition when a reliable warning exists — When a repeatable change genuinely comes before an attack, agree one safe response; if there is no warning, use planning that does not depend on it. [Specialist guidance and emerging model; preventive effect uncertain]

Working With Attention, Worry and the Cough Urge — Where threat, vigilance or stress amplifies the urge, treatment may include attention shifting, paced exposure or psychological care. This does not imply that the cough is fabricated. [Professional consensus; individual assessment required]

Working With Fear of Choking Without Pressure — Swallowing/globus: When fear or vigilance is restricting eating after safety has been assessed, including after a frightening event. [Professional consensus; preliminary formulation-based evidence, not a universal exposure protocol]

Working With Worry and Attention During Vestibular Rehabilitation — PPPD: When symptom-related worry, constant monitoring or an assessed avoidance pattern makes rehabilitation harder and the person wants help with it. [Emerging CBT-informed package evidence; not proof of psychological causation]

Scope and gaps

The pages cover the same 17 presentations as the current diagnostic-sign reference. They do not yet cover every reported FND-associated symptom. Hearing changes, bladder symptoms, breathing-pattern disorder outside functional cough/upper-airway symptoms, dissociation without seizures, pain, fatigue and several less common movement presentations require their own research package before symptom-specific technique pages are added.

Index created: August 25, 2026 · Functional paralysis and drop attacks added September 2, 2026 · Functional limb weakness entries expanded September 10, 2026 · Functional tremor and functional jerks entries expanded September 11, 2026 · Functional dystonia and functional gait entries expanded September 12, 2026 · Functional seizure entries expanded September 14, 2026 · Clinical and accessibility review pending

Options for co-occurring conditions

These nine condition overviews contain initial treatment and recovery lists, separate from the FND symptom techniques above. They are not additional FND diagnoses or counts of proven FND treatments. Evidence labels and limits appear beside each option.

Migraine Alongside FND

• An attack plan
• Preventive treatment
• Specialist options for chronic migraine
• Reviewing frequent rescue-medication use
• A manageable daily rhythm
• Selected procedural or non-drug options
• Migraine-focused behavioural treatment

Persistent Headache Alongside FND

• Match treatment to the headache pattern
• Consider prevention
• Make acute relief sustainable
• Consider acupuncture for chronic tension-type headache
• Use a pain rehabilitation plan when pain remains

Tinnitus Alongside FND

• Hearing assessment and explanation
• Hearing aids when hearing loss is present
• Tinnitus-focused CBT
• Comfortable background sound
• Treat persistent insomnia
• Adjust everyday listening and demands

Persistent Pain Alongside FND

• A shared explanation and meaningful goals
• Individually adapted movement
• Activity planning and occupational therapy
• Pain-focused CBT or acceptance and commitment therapy
• Selected medicines
• Acupuncture in appropriate services

Fibromyalgia Alongside FND

• An understandable explanation and priorities
• Adapted aerobic or strengthening activity
• Pacing and practical task changes
• Psychological treatment when useful
• Selected medication for the main difficulty
• Coordinated rehabilitation for substantial disability

Fatigue and Post-Activity Worsening Alongside FND

• Identify treatable contributors
• Plan around available energy
• Use equipment and practical help
• Make activity adjustment symptom-led
• Treat coexisting insomnia or other sleep problems
• Review what the plan actually achieves

Insomnia and Sleep Difficulties Alongside FND

• Multicomponent CBT-I
• Rebuild the bed–sleep connection
• Adjust sleep timing with clinical guidance
• Reduce the struggle around sleep
• Make the surroundings and routine supportive

Autonomic Symptoms Alongside FND

• Understand the measured pattern
• Use practical upright-tolerance strategies
• Discuss fluid, salt and compression where appropriate
• Adapt physical rehabilitation to the pattern
• Discuss targeted medication if needed
• Reduce unnecessary daily effort

Irritable Bowel Syndrome Alongside FND

• Match care to the bowel pattern
• Review meals and fibre
• Consider a dietitian-supported low-FODMAP trial
• Use subtype-directed medicines
• IBS-focused CBT
• Gut-directed hypnotherapy
• Plan access around real life