Functional neurological disorder

FND-এর কারণ কী?

আমরা জানি, মস্তিষ্ক নিজের ভেতরে এবং শরীরের অন্যান্য অংশে যেভাবে বার্তা পাঠায় ও গ্রহণ করে, তাতে সমস্যা হওয়ার কারণেই FND-এর উপসর্গগুলো দেখা দেয়। গবেষণার বিভিন্ন পদ্ধতি ব্যবহার করে বিজ্ঞানীরা দেখতে পেয়েছেন যে FND আক্রান্ত মানুষের মস্তিষ্কের কিছু নির্দিষ্ট সার্কিট ঠিকমতো কাজ করছে না।

তবে FND কীভাবে এবং কেন হয়, তা পুরোপুরি বোঝার জন্য এখনও অনেক গবেষণা বাকি আছে।

FND কেন হয়?

নানা কারণে FND হতে পারে। প্রায়ই এর পেছনে একটির বেশি কারণ থাকে, আর একেকজনের ক্ষেত্রে এই কারণগুলো একেবারেই আলাদা হতে পারে।

FND-তে মস্তিষ্ক ঠিকমতো কাজ করা বন্ধ করে দেয়। এর কয়েকটি কারণ হলো:

• কোনো যন্ত্রণাদায়ক অনুভূতি থেকে মুক্তি পেতে মস্তিষ্কের চেষ্টা
• মাইগ্রেন বা স্নায়ুজনিত অন্য কোনো উপসর্গ
• মানসিক চাপ থাকলে, অথবা মস্তিষ্ক কোনো পরিস্থিতিকে বিপজ্জনক মনে করলে, তার প্রতিক্রিয়ায় মস্তিষ্ক শরীরের কোনো অংশ বা পুরো শরীরকেই অচল করে দেয়

কারও কারও ক্ষেত্রে অতীতের বা বর্তমানের মানসিক চাপের ঘটনা FND-এর সঙ্গে জড়িত থাকতে পারে। PTSD (পোস্ট-ট্রমাটিক স্ট্রেস ডিসঅর্ডার), বিষণ্নতা বা উদ্বেগের মতো মানসিক সমস্যাও এর সঙ্গে জড়িত থাকতে পারে। আবার অনেকের ক্ষেত্রে এগুলোর কোনো ভূমিকা থাকে না।

আপনার যদি অন্য কোনো স্নায়ুরোগ থাকে, তাহলে FND হওয়ার ঝুঁকি বেড়ে যায়। অটিজম বা অ্যাটেনশন ডেফিসিট হাইপারঅ্যাক্টিভিটি ডিসঅর্ডার (ADHD)-এর মতো সমস্যা থাকলেও এই ঝুঁকি বাড়তে পারে।

Diagnosing FND

When diagnosing FND, your healthcare provider will carry out an assessment to see if there are typical clinical features of FND.

Your healthcare provider may still choose to test for other diseases and conditions before diagnosing FND. This is because many conditions share the same symptoms and, in around a quarter of cases, FND is present alongside another neurological condition. Someone can have both FND and conditions like sciatica, carpal tunnel syndrome, epilepsy, or multiple sclerosis (MS).

The diagnosis of FND, however, should be given because you have the clinical features of FND. It shouldn’t be given just because there’s no evidence of other conditions or illnesses.

Because the symptoms of FND are not always there, your healthcare provider may ask you to video your symptoms. This will allow them to see what your symptoms look like.

Treatments

FND is a really variable condition. Some people have quite short-lived symptoms. Others can have them for many years.

There are treatments available that can manage and improve FND. These treatments are all forms of rehabilitation therapy, which aims to improve your ability to carry out every day activities. Many of these treatments are designed to ‘retrain the brain’. Some people with FND benefit a lot from treatment and may go into remission. Other people continue to have FND symptoms despite treatment.

Specialised physiotherapy can be useful in treating FND. It helps to remind the body how it should move. It can also help you build up strength and stamina you may have lost.

Read more about physiotherapy for FND

Occupational therapy can be helpful in treating FND. An occupational therapist will work with you to plan your treatment goals, and gradually build your confidence and ability to reach them.

Read more about occupational therapy for FND

Psychological therapy can be helpful to many people with FND, even those without stress in their lives. It can help you gain a better understanding of FND and its relationship to your personal circumstances.

There are specific psychological techniques which can help you gain better control over movement or seizure symptoms. Psychological therapy can also help you learn to manage low mood, anxiety and past traumatic events, as well as other psychological problems (if present).

Not everyone with FND will need psychological therapy.

Read more about psychological therapy for FND

Speech and language therapists are available to help if you’re struggling with speaking or swallowing. They have a range of techniques to try, designed to help with specific problems. These might include helping you to shape certain sounds, or to practice breathing patterns as you try to talk.

Read more about speech and language therapy for FND

Medication can play a role in treating the some of the problems associated with FND, like pain, depression and anxiety. Your healthcare provider can help decide if medication is right for you.

There are many types of medication that can make FND worse, including opiates like morphine, dihydrocodeine or codeine. It may be worth discussing your current medications with your healthcare provider.

Stopping medication

Do not stop taking any medicine that’s been prescribed without checking with your GP or healthcare provider first. You could make yourself very ill.

Read more about treating FND

FND in children and young people

FND is broadly the same condition in children and young people. It’s unusual for it to occur under the age of 10. It becomes more common through the teenage years.

The treatment for FND in children and young people is similar to adults. It’s especially important for families and schools to learn about the condition, so they can respond in the most helpful way.

Where to find support

If you’ve been diagnosed with FND there are sources of information, charities and support groups that can help you.

The Neurosymptoms FND Guide has more detailed information. There’s also an app available with further details about the condition.

My FND is an app that allows you to learn about your symptoms. It helps you track them, and offers advice for managing them.

FND Action is a charity that provides information on FND and support for those with a diagnosis.

Right Decision Service: Dissociative Seizures is a resource for people with functional seizures.

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