Patient education: Functional neurological symptom disorder (The Basics)

What is functional neurological symptom disorder? — 

People with functional neurological symptom disorder, or "FND," have symptoms like weakness and trouble moving their body normally.

In FND, the brain and nerves do not work correctly, but there is no clear physical cause.

FND is sometimes called "conversion disorder." Many doctors no longer use that term, because it suggests that a person is "converting" mental stress into physical problems. People with FND have real symptoms that are often distressing and get in the way of daily life.

What causes FND? — 

Experts do not know exactly what causes it. There are different theories about the relationship between a person's mental state, experiences, and physical health. This is complicated, and there is no specific known cause of FND or way to prevent it.

FND might be more common in people who also have:

●Depression or anxiety

●Personality disorders

●Certain medical conditions, for example, irritable bowel syndrome, migraine, epilepsy, or stroke

Experts also think that for some people, FND can be "triggered" by a stressful event, injury, or illness. But this is not always the case.

What are the symptoms of FND? — 

Different people can have different symptoms. These can include:

●Behaviors that look like seizures

●Weakness or numbness in part of the body

●Not being able to move part of the body

●Abnormal movements, like tremors, twitching, or trouble walking

●Problems with speech, like whispering or a hoarse voice

●Problems with sight, like blurry vision or double vision

●Problems with thinking or memory

●Feeling like there is a lump in the throat

●Other sensory symptoms, like problems with hearing, smell, or reacting to touch

Symptoms can come and go, or they can be constant.

Will I need tests? — 

Maybe. Your doctor or nurse will do a careful physical exam and check your muscle strength and movement. They will ask questions about your symptoms and other health conditions. They will also test your thinking and memory.

They will also order tests to see if something else might be causing your symptoms. Tests might include:

●Blood tests

●Imaging tests of your brain, such as MRI

●Other tests to check how your brain and nerves are working

The results of these tests are usually normal in people with FND.

How is FND treated? — 

The first step in treatment usually involves learning about FND and how doctors diagnose it. It can be frustrating to be told that your symptoms are real but there is no specific physical cause. But accepting this is often the first step to improving. It can help to work with a doctor who understands FND.

For people who continue to have symptoms, other treatment options might include:

●Physical therapy – This usually involves practicing normal body movements like standing and walking. Techniques to distract you from focusing on the affected body part might also help. Your doctor can work with you to make a specific plan for increasing physical activity at a comfortable pace.

●Psychotherapy – This involves talking with a mental health counselor. This could be a psychiatrist, psychologist, nurse, or social worker. There are different types of psychotherapy. In general, they all focus on helping you learn new ways of thinking and behaving.

●Speech therapy – This might help if you have symptoms that affect your speech or communication.

●Occupational therapy – This can help you do regular daily activities.

Treatment will depend on your situation, symptoms, and other health problems. If the things above do not help, your doctor might suggest other options. For example, if you have depression or anxiety in addition to FND, medicines can help.

What will my life be like? — 

This is hard to predict. Some people do improve or recover. But many people with FND continue to have symptoms for a long time. Having a good relationship with your doctor can help.