Every now and then a member of our community will ask if a Functional Neurologist is an appropriate type of doctor to see for autoimmune encephalitis. Initially, a neurologist and/or Neuroimmunologist is the type of doctor a patient should see for autoimmune Encephalitis. Immunologists and Rheumatologists are other types of physicians you may encounter on a care team.  Additionally, you can expect psychiatry, psychology, speech, occupational therapists – and others.  Usually, visits to neurologists/neuroimmunologists/etc require a referral – or at least can be expedited by an initial visit to a primary care MD – or in urgent situations to a hospital emergency room.  Unless the doctor is a specialist in autoimmune neurology, they will likely refer the patient to a physician with those specialties.

What is Classic neurology – and what is Functional neurology?

Classic Neurology – requires an MD degree – and postgraduate training (Up to 4 years for a neurology residency – and then 1 or 2 years for a neuroimmunology fellowship).  Though MDs can become functional neurologists.  Most practitioners of functional neurologists are Doctors of Chiropractic (D.C.).  There is some overlap – as some patients who see a classic neurologist also can see a functional neurologist.  An analogy might be – a person seeing a psychiatrist and a psychologist at the same time.

Training Required: 

“To become a board-certified functional neurologist, you have to undergo 350 credit hours of extra training (specifically in functional neurology) after completing an MD (Doctor of Medicine), DO (Doctor of Osteopathic Medicine), DC (Doctor of Chiropractic), ND (Naturopathic Doctor), or PT (Physical Therapist). That said, the vast majority of practicing functional neurologists are chiropractors.”

If you decide to visit a functional neurologist, make sure they are properly credentialed. “Functional neurologist” is not intended to be a title anyone can grant themselves. They should be certified by the American Chiropractic Neurology Board”

Is Functional Neurology Legitimate?

Functional neurology is a recognized specialty.  Many functional neurologists have happy patients (and this is no small feat, considering the difficulty and range of their ailments). It is difficult to say with certainty exactly which aspects of a patient’s recovery are due to functional neurology and which aspects are due to things such as lifestyle changes or the placebo effect, which can sometimes be more powerful the more complicated the treatment provided.”

This is not to say that functional neurology isn’t a legitimate treatment. But from a strictly scientific perspective, there is more work to do for functional neurologists to demonstrate:

1. The scientific explanations (reviewed above) for why patients suffer the ailments they do.
2. The extent to which their treatments contributed to patient recovery.

3. If there is one criticism we would mention here, it’s that many of the functional neurology studies conducted have been with such small groups of people that, statistically speaking, you can’t adequately draw conclusions about what happened. In our own research onEPIC treatment, we’ve used large numbers of subjects and attempted to control for placebo by comparing patients who do EPIC treatment with patients who do not undergo treatment of any kind. We do think that functional neurology would benefit from more rigorously designed research studies.
4. Again, that’s not to say that whatever treatment a functional neurologist chooses won’t work. Whether you want to give functional neurology a try is your decision. Most of the therapies and techniques used are at the very least harmless and in many cases appear to help patients. However, any treatment program is an investment of time and money, so it’s worth asking if there’s a better alternative for your condition.

The bottom line – it probably won’t hurt – but it will not (alone) cure/or help the underlying disease process of immune-mediated encephalitis, but may help with symptom relief and improvement of the patient’s feeling of well-being.

References:

The Downside of Functional Neurology After Brain Injury

Unravelling functional neurology: a critical review of clinical research articles on the effect or benefit of the functional neurology approach

Functional neurology – more chiro-quackery?

Unraveling functional neurology: a critical review of clinical research articles on the effect or benefit of the functional neurology approach