An introduction to functional neurological disorder (FND)

Leading consultant psychiatrist Dr Michael Newson tells us all about functional neurological disorder (FND) in this informative article.

What is functional neurological disorder (FND)?

Functional neurological disorder (FND) is a condition where patients experience neurological symptoms that are not attributed to a structural or biochemical cause in the nervous system. These symptoms can include movement disorders, sensory issues and seizures, which appear similar to conditions like multiple sclerosis or epilepsy but don't have the same underlying causes.

What are the symptoms of FND?

FND symptoms can vary widely and may affect different parts of the body. Common symptoms include:

• Weakness or paralysis in the limbs.
• Tremors, spasms or other involuntary movements.
• Difficulty walking or maintaining balance.
• Non-epileptic seizures or episodes.
• Sensory disturbances, such as numbness or tingling.
• Visual and hearing impairments.
• Speech difficulties, such as stuttering or loss of speech.

These symptoms can appear suddenly and may fluctuate in severity. They can significantly impact daily functioning and quality of life.

What causes FND?

The exact cause of FND is not well understood. It’s believed to result from a complex interaction of psychological, biological and social factors. Stress, trauma and certain personality traits may contribute to the development of FND. Additionally, some research suggests that abnormal brain function, particularly in areas responsible for emotion and movement control, may play a role.

How is FND diagnosed?

Diagnosing FND can be challenging due to its overlap with other neurological conditions. Diagnosis typically involves:

Detailed medical history

This includes a thorough review of symptoms, personal and family medical history, and any psychological factors.

Neurological examination

A comprehensive physical and neurological examination helps to identify patterns consistent with FND.

Diagnostic tests

Imaging studies (MRI or CT scans) and other tests (EEG) are used to rule out other neurological conditions.

The diagnosis of FND is made when symptoms are consistent with the disorder and other potential causes have been excluded.

What are the treatment options for FND?

Treatment for FND is multi-faceted and often involves a combination of medical, psychological and rehabilitative approaches. Common treatments include:

Education

Patients are educated about the nature of FND to help them understand that their symptoms are real but not caused by structural neurological disease.

Psychological therapy

Cognitive behavioural therapy (CBT) and other forms of psychotherapy can help address underlying psychological factors, manage stress and improve coping strategies.

Physiotherapy

Physical therapy focuses on improving movement, strength and coordination. Tailored exercises can help patients regain function and confidence.

Occupational therapy

This therapy helps patients adapt to daily activities and improve their quality of life.

Medication

While there’s no specific medication for FND, medications may be prescribed to manage symptoms such as pain, depression or anxiety.

How effective are these treatments?

The effectiveness of FND treatment varies among individuals. Many patients experience significant improvement with a comprehensive, multidisciplinary approach. Early diagnosis and intervention are crucial for better outcomes. Continuous support and follow-up are essential to address any recurring or new symptoms.

Can FND be prevented?

There is no known way to prevent FND. However, managing stress, seeking prompt treatment for psychological issues and maintaining a healthy lifestyle may reduce the risk of developing the disorder. Building resilience and coping strategies can also be beneficial.

FND is a complex condition with a broad range of symptoms that can significantly impact a patient's life. Understanding the nature of FND and its treatment options is crucial for managing the condition effectively. If you or someone you know is experiencing symptoms of FND, seeking medical advice is important to obtain a proper diagnosis and begin appropriate treatment.

If you’re concerned about functional neurological disorder, arrange a consultation with Dr Newson via his Top Doctors profile.