Current Opinions and Practices in Functional Neurological Disorders: A Survey of Indian Neurologists

Abstract

Background and Objectives: Functional neurological disorders (FNDs) are common in clinical practice and a significant cause of disability. In India, the presentation of FNDs is influenced by socio-cultural factors, yet there is limited research on how FNDs are perceived and managed. This survey aimed to explore the diverse clinical experiences of Indian neurologists on FNDs, including the diagnostic and management challenges they face. Methods: An online survey was sent to 1,571 neurologists across India, collecting 117 responses (7.45%) over 4 weeks. The questionnaire was designed to capture respondent demographics, FND precipitating factors and associated stigma, utilization of diagnostic tools, access to multidisciplinary teams, challenges in patient management, and engagement in FND research and societies. Results: Overall, 78.6% of the respondents preferred the term “functional.” Home-based videos (99.1%) and multidisciplinary teams (67.5%) were commonly used. Barriers included time constraints (73.5%) and prevalent myths surrounding FNDs (95.7%). Only 23.9% reported using neurophysiological tools in FND. Participation in FND-specific societies (3.4%) and research (12%) was remarkably low. Conclusions: Our survey highlights evolving trends and persistent challenges in FND care in India. While the adoption of “functional” terminology, home-based videos for diagnosis, and multidisciplinary approaches mark progress, barriers include time constraints, and prevalent myths. Underutilization of neurophysiological tools is a significant barrier, and professional engagement in FND research and societies is also limited. Enhancing education, specialized training, and professional engagement is essential for improving FND care.