What is Functional Neurological Disorder
Functional neurological disorder (FND) is a neurological condition that causes problems with the functioning of the nervous system, how the brain and body send and receive signals, rather than there being any changes in the structure of the brain which is seen in many neurological disorders. It is often compared to thinking of the brain as a computer, in FND there is no damage to the hardware (or structure of the brain), it is the software, the computer programming that is not running properly.
Symptoms
FND causes a mix of symptoms that will be slightly different for each individual. Intensity and dominance of symptoms can also vary within the individual. Symptoms can significantly interfere with how a person functions and copes with daily life. Symptoms can appear very suddenly. Many people find that they can increase as attention is drawn to them, and reduce if they are distracted.
Diagnosis
FND is classed as a rare disease, but an estimated 50,000-100,000 in the UK have FND. Between 60-75% of patients are female. FND is the second most common condition seen in Neurology clincis (the most common is headaches). A diagnosis is generally confirmed by a neurologist, or someone with specific expertise in diagnosing neurological conditions. Brain imaging (eg MRI and CT scans), and other neurological tests are normal in individuals with FND. A diagnosis is made with the presence of positive clinical features including functional limb weakness, functional movement disorders, functional or dissociative seizures and functional visual signs.
While there is no formal scan research studies using functional neuroimaging and neurophysiology (looking at how the brain works rather than what it looks like) show changes in the connections between different regions of the brain in people with FND, including regions involved in controlling movement, the sense of agency/controlling actions and controlling emotions and behaviours making it more challenging to regulate emotions and respond to stress
Pain
Pain can be located in any area of the body and may be in multiple locastions and vary from day to day. The intensity and type of pain may also vary daily without any apparent physical trigger.
Managing FND
Due to the range of symptoms, there is no single treatment for FND and s range of specialties may be involved in helping manage FND, including neurology, physiotherapy, psychiatry/psychology and occupational therapy.
There is no recognised medication to treat FND, although medication may be offered to help relieve symptoms such depression.
Physiotherapy can be useful to help with movement and motor symptoms with the focus being on “retraining the brain” rather than being focused on exercise.
Strategies such as pacing can be helpful to manage symptoms, including the impacts of pain.
Resources
FND Hope is a charitable organisation promoting awareness and support for individuals and carers affected by FND. The website has more detailed information about FND:
What Is FND – FND Hope International
This is a series of self-help videos developed by therapists at University College London Hospitals NHS Foundation Trust