Functional neurological disorder
Functional neurological disorder
Functional neurological disorder, or FND, is a problem with how the brain sends and receives signals to and from the rest of the body.
It may help to picture the brain as a computer. In someone with FND, there is nothing wrong with the computer's hardware, meaning the brain's physical structure. The trouble lies in the software, the program running on that hardware, which is not working the way it should.
The changes behind FND happen at a level of the brain that a person cannot consciously control. This is what leads to symptoms such as weakness in the arms or legs and seizures. Other symptoms, such as fatigue or pain, are not caused directly by FND itself, but they are often present alongside it.
Common Symptoms
⚠️ This symptom list is for educational purposes. Having these symptoms does not mean you have this condition. See a doctor for proper diagnosis.
Medicines Commonly Used
⚠️ These medicines are commonly used for confirmed diagnoses of this condition. This is NOT a recommendation or prescription. Treatment must be determined by your doctor.
No medicines have been linked to this condition yet.
Causes
What causes FND?
We know the symptoms of FND happen because of a problem with how the brain sends and receives messages to itself and other parts of the body. Using research tools, scientists can see that certain circuits in the brain are not working properly in people with FND.
However, there's still a lot of research to be done to understand how and why FND happens.
Why does FND happen?
FND can happen for a wide range of reasons. There's often more than one reason, and the reasons can vary hugely from person to person.
Some of the reasons why the brain stops working properly in FND include:
- the brain trying to get rid of a painful sensation
- a migraine or other neurological symptom
- the brain shutting down a part or all of the body in response to psychological stress or a situation it thinks is threatening
In some people, stressful events in the past or present can be relevant to FND. Psychological conditions like PTSD, depression or anxiety can also be relevant. In other people, these things are not relevant.
The risk of developing FND increases if you have another neurological condition. It may also increase if you have a condition like autism or attention deficit hyperactivity disorder (ADHD).
Diagnosis
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.
Treatment
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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