The definition of functional neurology, according to the Functional Neurology Society, is the following: “Functional neurology is based on the principles of neuroplasticity. The various parts of your nervous system can be altered to work more efficiently and even regenerate. The goal of a Functional Neurologist is to optimize this remarkable ability.”
Neuroplasticity is the nervous system’s ability to reorganize itself by forming new connections between neurons throughout life. This is the mechanism by which Functional Neurology stands for.
The gold standard of imaging is the MRI, which offers endless amounts of information. However, it is mainly used for looking at the structure of the brain and observing if there are any abnormalities such as lesions, plaques, tumors, etc. This is why a lot of our patients with neurological conditions or symptoms are told that everything is “normal” after they have imaging and a standard neurological exam that is negative or within normal limits.
The one thing it cannot offer is the ability to test the function of a certain area of the nervous system. One of the only ways, and best ways, to test the function of the nervous system, is to perform a very comprehensive functional neurological examination.
In a detailed functional neurological examination, we look at multiple areas of the nervous system. After taking a detailed history, we then correlate that information with our exam. For example, if a patient was swaying a lot of on balance test, but didn’t lose their balance of fall over it would typically be labeled as “within normal limits” or “negative.” In functional neurology, we note the direction of the sway, if the patient got better or worse as the test went on or if the swag was gradual/slow or sharp/fast. The big difference in a functional neurological exam is that we look for subtle changes and always compare to the opposite side of the body. These are the subtleties we look for with any test. The tests incorporate everything from vitals, balance, gait, reflexes, motor testing, sensory testing, coordination testing, cranial nerve exam, eye movements, vestibular-ocular reflexes (VOR), and much more.
After completing the exam, we then put the findings together and try to develop a plan for the INDIVIDUAL patient. If ten patients came in with a headache, there could be a different mechanism in every patient that is causing their INDIVIDUAL set of symptoms. The human body is very complex, which is why it’s important to look at every patient on a personalized level.
We determine the course of action by applying different forms of sensory input into the nervous system and retesting parts of the exam that we found were not functioning to their capacity. The procedures modalities that we use include light, sound, smell, vibration, manipulations (extremity and spine), complex movements of extremities, specific eye movements, balancing exercises, vestibular exercises and much more. We need to be specific and activate the areas of the nervous system that aren’t doing enough and also decrease the amount of activation in the areas that are doing too much. Each patient will likely have different exercises and different amount of sets, reps, etc. The reason for this is that each patient can tolerate different amounts of stimulation and we’re not going to focus on areas of the nervous system that are already doing their job and functioning well. We also do not want to push a patient into symptoms.
To schedule an free initial phone call with Dr. Paul Deglmann, call our office at (952) 479-7801 or send us an email at RHSofficeMN@gmail.com