What is your treatment approach to functional cervical dystonia?

If I am confident that the diagnosis is correct, I generally would treat functional cervical dystonia the same way as any other functional disorder. This includes evaluation of high-risk mental health factors and ideally referral to mental health treatment.

In some individuals, functional disorders can coexist with other conditions that might be amenable to botulinum toxin injections; however, the botulinum toxin would be directed toward these comorbid conditions and not specifically for the fun...

This is a relatively common situation. After making sure of the diagnosis of functional cervical dystonia, I explain the reversibility and fluctuation with mood changes (that may or may not be perceived by the patient) and demonstrate that they DO have some control over their movements through distracting manoeuvres. Then I pose the question if they think they need more help (if symptoms are mild). I proceed to refer them to our FMD clinic (equipped with PT, OT, ST, psychology and psychiatry) if...