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Understanding Functional Neurological Disorder (FND)

Apr 24, 2025

Functional Neurological Disorder (FND): A Patient's Guide

Overview of FND

  • Functional Neurological Disorder (FND) involves neurological symptoms such as limb weakness, tremor, numbness, or blackouts.
  • Symptoms are related to problems in the functioning of the nervous system, akin to a "software issue" of the brain rather than a "hardware issue" like in stroke or MS.
  • It is characterized by positive diagnostic features typical of FND, causing day-to-day difficulties.
  • FND is common but often misunderstood by both patients and health professionals.

Symptoms

  • Multiple symptoms are common in individuals with FND.
  • Detailed symptoms include:
    • Functional Limb Weakness
    • Functional Seizures
    • Functional Movement Disorders
    • Functional Sensory Symptoms
    • Functional Tremor
    • Functional Cognitive Symptoms
    • Functional Dystonia
    • Functional Speech and Swallowing Symptoms
    • Functional Gait Disorder
    • Functional Dizziness (PPPD)
    • Functional Facial Symptoms
    • Functional Jerks and Twitches
    • Functional Tics
    • Bladder symptoms associated with FND
    • Functional Drop Attacks
    • Visual Symptoms

Common Associated Symptoms

  • Fatigue
  • Dissociative Symptoms
  • Pain
  • Sleep Problems
  • Headache
  • Post-Concussion Syndrome
  • Anxiety and Panic
  • Health Anxiety
  • Complex Regional Pain Syndrome
  • Low Mood
  • IBS, Chest, and other symptoms

Causes

  • Brain imaging and clinical studies are beginning to elucidate the dysfunction of the nervous system in FND patients.
  • Factors include:
    • Misdiagnosis/Comorbidity
    • FND is not imagined
    • Ten myths of FND
    • FND and its relation to other functional disorders

Treatment

  • Focuses on rehabilitation, understanding the condition, and retraining the brain.
  • Various treatments include:
    • Physiotherapy/Activity
    • Occupational Therapy
    • Psychological Therapy
    • Speech and Language Therapy
    • Medication
    • Family and Work considerations
    • Specific treatments for Functional Seizures, Limb Weakness, Tremor/Movement problems
    • Strategies for Managing Relapses
    • Addressing challenges when conventional treatments are ineffective

Patient & Professional Organisations

  • FND Hope: An international charity run by patients for patients
  • FND Action: Provides information with a UK focus
  • FND Australia: Offers support and information in Australia
  • Functional Neurological Disorder Society: A professional society for those interested in FND
  • FND Dimensions: A UK charity focusing on patient-led support groups
  • FND Ireland: Advocates and supports individuals with FND in Ireland

Author: Professor Jon Stone

  • Consultant Neurologist and Honorary Professor in Neurology at the University of Edinburgh
  • Research focuses on the clinical features and treatments of FND
  • Involved in research with colleagues since 1999 to improve understanding and attitudes towards functional disorders

Additional Resources

  • FND app available for download on Android and iOS
  • Disclaimer: The website is not a diagnostic tool and reflects the views of the author alone
  • Funded by the Scottish Government
  • Links to stories, media, and FAQ for further information