Ask The Expert - Functional Neurological Disorders & PPPD

Dizziness is a common symptom in neurology and has a lot of different causes - migraine, middle ear problems (vestibular disorders like BPPV or labyrinthitis), and drug side effects. Dizziness occurring as part of a functional disorder is also relatively common, accounting for up to 20% of patients seen in a specialist dizziness clinic. When dizziness occurs as a functional disorder it is called Persistent Postural Perceptual Dizziness (PPPD). Other names for it include Visual Vertigo, Phobic Postural Vertigo, Functional Dizziness, Chronic Subjective Dizziness, or Space Motion Discomfort. In this episode of Ask the Experts, Prof. Jon Stone explains what a functional neurological disorder is and how PPPD is diagnosed and treated. Speaker Bio Professor Jon Stone is an NHS Consultant Neurologist and Honorary Professor of Neurology in Edinburgh. He has had a research interest in functional disorders in neurology since 1999. He has published widely in the area including systematic reviews, large cohort studies, imaging studies and treatment studies. He led on new diagnostic criteria for functional disorders in DSM-5 and ICD-11 and the development of professional organisations in the area. In 2016 he co-edited the volume ‘Functional Neurologic Disorder’ (ed Hallett, Stone, Carson) Elsevier 2016 setting a new standard for a teaching and research curriculum. In 2009 he made a website for patients at www.neurosymptoms.org which has been translated by other neurologists in to 12 other languages and receives 60,000 visits a month. He runs a weekly clinic for patients with functional movement disorders and dissociative (non-epileptic) seizures and as of August 2012 is a National Research Strategy Clinician (NHS Scotland). In 2014 he was awarded the RCP Jean Hunter Prize for Nervous Disorders. In 2017 he was awarded the President's Medal by the Royal College of Psychiatrists. He has given invited plenary sessions at the World Congress of Neurology, American Academy of Neurology and Movement Disorders Congresses as well as lectures to 18 neurology department in the UK and grand rounds at Harvard and Stanford. In 2017 he co-chaired a landmark international conference in Edinburgh on FND with 561 delegates. In 2018 he was promoted to honorary Professor of Neurology at the University of Edinburgh. In December 2018 he received the honorary title of Adjunct Professor of Functional Disorders in Neurology at the University of Southern Denmark. In 2019 he became founding Secretary of the new Functional Neurological Disorder Society (www.fndsociety.org). In 2020 he was awarded the Ted M Burns Award for Humanism in Neurology by the American Brain Foundation for his work in FND. Professort Stone currently (2018) runs a weekly clinic for patients with functional movement disorders and dissociative (non-epileptic) seizures at the Western General Hospital in Edinburgh. Stone is unable to see referrals from outside South East Scotland, does not carry out private practice, and still receives more clinical referrals than he can personally see. Professor Jon Stone is keen to improve clinical understanding and treatments for patients with functional neurological symptoms. He states “I believe the best way to do this is through clinical research and by providing good educational and self-help resources to improve knowledge and attitudes among doctors and patients.”