Common Questions About Visiting the FND Clinic

What do I need to do before seeing your team?

Before scheduling a consultation with our team, you need to have had a general neurological assessment that shows that FND is the likely (or suspected) diagnosis, and to send us a copy of that assessment. We also appreciate receiving copies of any other neurological, medical, or psychiatric assessments you have had in the past – including details of prior brain imaging, EEG data or other testing data that have been acquired outside of Mass General Brigham. This allows us to ensure that we understand the full picture when we see you for an assessment.

What can I expect at my first appointment?

Your first appointment will be booked with a member of our physician team – either a neurologist or neuropsychiatrist with subspecialty expertise in FND. Our intake appointments are approximately 90 minutes in duration. During this appointment we will go over:

1. Your current symptoms
2. The narrative of how these symptoms started and progressed
3. A medical, psychiatric, and social history
4. a complete neurological examination

Based on this assessment we aim to confirm your diagnosis, provide education, and start putting together a detailed treatment plan. Any additional testing we think needs to be done (for example, an MRI or EEG) will be booked separately.

Do you offer inpatient treatment or intensive outpatient therapy?

At this time, we only offer routine (non-intensive) outpatient care for our FND patients. This translates to seeing a member of your therapy team once every 1-2 weeks (e.g., the frequency of outpatient physical therapy), on average, during the course of treatment. As you progress and your symptoms improve, we may space out appointments further to give you a chance to practice what you have learned with our therapy team at home and best support your needs. The physician member of the team generally sees patients in follow-up about once every 3-4 months. The goal of physician follow-up visits is to assess progress being made and identify any barriers that may be limiting the potential benefits of the specific treatments being received.

How long will I be in treatment for my FND?

Duration of treatment varies by patient, depending on if/how your symptoms improve with treatment and at what pace that happens. Our physical therapists, occupational therapists, and speech and language therapists will work in collaboration with you to design an individualized treatment plan, usually delivered over a few weeks-months. We also offer short-term psychotherapy, usually lasting 8-16 sessions (for individuals with an already established outpatient psychotherapist – efforts will alternatively be made to have that individual involved in the treatment plan). You can expect to meet with members of your treatment team once every 1-2 weeks. You will receive long-term follow-up with your primary FND physician about once every 4 months, as needed.

What kind of time commitment can I expect in terms of my FND treatment?

Generally, we request that patients make themselves available to be seen by our treatment team either weekly or every other week, over a period of several months. You are an important, active participant in your own care! As such, your allied health team will also give you things to work on at home, between appointments.

Does seeing your team for a consult guarantee that I will have ongoing, long-term care with the team?

Not necessarily. It depends on what is going to be the most helpful for you, based on our assessment. In some circumstances, our team might not be the best fit to help with your symptoms. For example, if you mainly have a problem with chronic pain, we might refer you to a multidisciplinary chronic pain team, instead of having our FND team follow up with you. Also, if we determine that more general neurology or general psychiatry needs appear to be predominant concerns, we will encourage you to continue to work with outside providers in those specialties.

Do you see pediatric patients (patients less than 18 years old)?

At this time, we only accept referrals for patients over the age of 18. We are unable to evaluate any potential referrals until after the individual has already turned 18.

Do you accept referrals for patients from outside Massachusetts and the New England area?

Yes, we accept patient referrals from out-of-state. For our out-of-state patients, especially those beyond New England, we offer the opportunity for a consultation with a physician member of our team. At this appointment, we will aim to confirm your diagnosis and offer treatment suggestions. However, if you are coming from outside New England, we will typically recommend that you get connected to care in the area where you live for treatment. We will send our assessment from your visit and treatment suggestions to your local care team, with your permission.

Do you accept referrals for international patients outside the United States?

We accept referrals for international patients on a case-by-case basis – primarily for one-time consultations or a second opinion. More information about the general procedures for international referrals can be found at massgeneral.org/international.

I also see another neurologist, psychiatrist, or psychologist for a different issue (for example, migraines or depression). Will you take over this care?

No. You will be expected to continue seeing your regular neurological or mental health care providers for non-FND-related care. This includes having your regular care providers continue managing prescriptions for your medications. To ensure that your care is coordinated, we can share copies of clinical notes with them, with your consent.

I am applying for disability. Can you help me fill out this paperwork?

We cannot complete any disability paperwork for you at your first appointment. We generally ask that this type of paperwork be completed by your primary care provider (PCP), who can access our notes via medical records and incorporate our findings into their report. Please call the Massachusetts General Hospital operator at 617-726-2000 and ask to be connected to medical records to get a copy of our clinical notes.

I want to give back to the Mass General FND Unit. How can I contribute?

That’s wonderful and thank you for your support! There are a number of ways you can give back to the FND community, including volunteering for research studies or by donating to our Unit to aid new clinical and research initiatives.