Functional neurologic disorder (FND) is a condition where a person develops symptoms that are not consistent with a neurological disease or other health condition, but they impair the person’s ability to function.
Often, people with FND may find it difficult to accept or even recognize their challenges, especially without a physical explanation for symptoms.
In this article, you will learn about FND, who is likely to develop this condition, and how it can be managed for a better quality of life.
In FND, there’s nothing mechanically wrong with the nervous system, but other physical or psychological stressors can create symptoms.
Many FND symptoms fall under the umbrella of movement disorders. These symptoms can include things like sudden or short-term paralysis. However, there are also times when FND can appear with behavior changes and speech problems.
There are many causes of FND. One of the main triggers is previous physical or mental trauma. In a way, FND is seen as a protective mechanism. It may be your mind and body’s way of protecting you from remembering or reliving a difficult event in your past.
FND and conversion disorder are the same condition. “Conversion disorder” is an older name for it.
Conversion disorder was first described by neurologist Sigmund Freud more than a century ago as a form of hysteria.
However, newer functional imaging scans of the brain have helped healthcare professionals better diagnose and understand this condition. The updated name, FND, reflects a wider clinical description and acceptance of what was once known as conversion disorder.
FND may be referred to by a number of names, even though they all describe the same condition. Some other names for FND include:
- functional neurological symptom disorder
- functional movement disorder
- conversion disorder
- psychogenic seizures/movement disorder
- dissociative seizures/motor disorder
- nonepileptic seizures
While there aren’t really different types of FND, the condition may earn different titles based on the symptoms that appear. Below are some common ways to group symptoms with FND.
Seizure-type FND
Psychogenic nonepileptic seizures (PNES) are nonepileptic seizures that can appear with FND. Although there may be other causes for these seizures, people with FND who have seizures may be considered a part of this subgroup.
Motor FND
This is the designation given to people with FND who experience motor symptoms like paralysis and other movement problems.
Other FND
Another type of FND refers to people who experience symptoms that are different from movement issues but demonstrate other brain functions, like speech, sensation, and cognition.
Depending on your particular symptoms with FND, you may experience:
- paralysis
- leg or arm weakness
- tremor
- tics
- involuntary movements
- muscle contractions
- walking or gait problems
- poor balance or posture
- muscle stiffness
- slow movements
- fatigue
- chronic pain or headaches
- slurred speech
- confusion
- memory loss
- numbness
- hearing loss
- vision changes
People who have experienced psychological or physical trauma have a higher risk of developing FND. This includes people with a history of:
- sexual abuse
- childhood abuse
- family dysfunction
- anxiety
- depression
- exposure to violence
- physical injury
- infectious illnesses
Not just psychiatric issues
Many people with FND do have other mental health conditions that sometimes stem from past mental or physical trauma. But this does not mean all people with FND have had this experience.
You do not need to have depression, anxiety, or a history of psychological trauma to develop FND.
There’s no official test to diagnose FND. Instead, a doctor can make an FND diagnosis when positive physical and neurological signs and symptoms are present.
A doctor will also rule out other neurological problems, like a stroke or seizure disorders, before making an FND diagnosis. To do this, they may use a number of blood tests, movement tests, and imaging tests.
If no physical explanation is found for your symptoms, your healthcare team may look to prior experiences and traumas as an explanation for your symptoms.
There’s no singular medication that is used to treat FND.
However, some people use medications to treat anxiety and depression.
Cognitive and behavioral therapies are the hallmark of treatment for FND. These therapies focus on helping people understand their disorder and cope with the past traumas that can trigger symptoms.
Physical, occupational, and speech therapy can also help people manage symptoms.
Keep in mind
People with FND have described frustration at getting others to believe or understand the reality of their symptoms. FND symptoms may not be visible or apparent to others. Symptoms can be difficult to explain through medical testing.
However, it’s important to note that the person’s symptoms are real. They are not “faking it.”
Understanding, recognizing, and accepting this condition are important when it comes to having a good quality of life with FND.
Functional neurologic disorder (FND) is a condition where a person develops symptoms that are not consistent with a neurological disease or other health condition. However, symptoms still impair the person’s ability to function.
It can be challenging for people with FND to accept their condition since there’s no physical explanation for symptoms.
But while understanding and recognizing this disorder can be difficult, newer testing methods are helping doctors to better diagnose it and help people manage FND.