Functional Neurological Disorders: From Imaginary Illnesses
Treating Functional Neurological Disorders: A Quebec Clinic’s Success with the Predictive Brain Model
Table of Contents
Published December 9, 2025
Early Observations and the Rise of the CHUM Clinic
Around 2013, healthcare professionals began noticing perplexing cases of patients experiencing paralysis without detectable lesions or convulsions without epileptic activity.Pierre-Luc Lévesque,a physiotherapist then at Notre-Dame Hospital,initially attributed these symptoms to psychological factors,admitting,”We thought it was pretending or a quest for attention. But it was wrong. These people where realy suffering.”
Further examination, and discussions with neuropsychiatrist Laury Chamelian, led Lévesque to a 2013 consensus of experts from the United Kingdom recommending physiotherapy as a treatment for Functional Neurological Disorders (FND). Upon arriving at the Centre hospitalier de l’Université de Montréal (CHUM) in 2017, Lévesque established a commitee with Drs. Bérubé and Chamelian. Six months later, the CHUM Functional Neurological Disorders clinic, the first of its kind in Quebec, began accepting patients.
The clinic operates with an interdisciplinary team encompassing neurology,psychiatry,physiotherapy,occupational therapy,and neuropsychology,focusing on restoring lost functions rather than simply eliminating symptoms.
Adopting the Predictive Brain Model and Improved Outcomes
In 2021, the Clinic formally adopted the predictive brain model as its guiding framework. This shift moved away from earlier “conversion” theories. Dr. Berube notes the positive impact: “Since then, patients understand their disorder better, accept the diagnosis more easily and regain their abilities in 70% of cases. Sometimes, the simple fact of understanding the mechanisms of the disorder is enough to trigger an betterment.”
Rehabilitation as Companionship and Agency
Pierre-Luc Lévesque views rehabilitation as a collaborative process, stating, ”I see us as companions.” His interventions center on redirecting attention, reprogramming automatic movements, and demonstrating real capabilities thru exercises like walking backwards, playing ball, and using a metronome.
The goal is to shift focus away from the symptom, allowing the body to regain control.Lévesque explains, “Patients are shown how to control their symptoms.Each success gives them confidence. The patient then becomes the actor in his own rehabilitation - what we call the concept of agency.”