Mental Health

Functional Neurological Disorders (FNDs)

Overview

FND is an umbrella term for a variety of genuine neurological symptoms such as paralysis, movement problems, sensory problems, unexplained seizures, muscle problems which are caused by abnormal nervous system functioning but not structural disease. The symptoms may be similar to or may co-exist with a wide range of other conditions such as migraine, MS and epilepsy. FND does not usually cause any physical disabilities.

 

To understand this, let’s examine a malfunctioning computer. The most common reason a computer breaks is because of its “software” (programming and coding), not its “hardware” (keyboard, hard drive). You can think of FND in the same way: The hardware in your body (brain, nerves) isn’t damaged, but the software doesn’t work properly.

The causes of these disorders vary from person to person. The cause of functional neurological symptoms remains largely unknown. Research is being conducted on this topic. Functional neurological disorders rarely have a single cause. The following factors are thought to trigger or prolong symptoms in some people: 

  • Physical injury  
  • An illness that caused a lot of fatigue (tiredness) and bed rest  
  • Past or recent emotional event/trauma/complicated grief  
  • Current stressors  
  • Family history of illness/a neurological condition  
  • Concern about bodily symptoms/attention focused on symptoms  
  • Worry about the cause of symptoms  
  • High levels of anxiety 

 

For others, circumstances may accumulate over time. Many people are unable to identify the specific cause of these symptoms. Uncertainty about the diagnosis can lead to feelings of confusion, anger, and anxiety.

 

Different people have FND symptoms in different ways.

 

Symptoms can include:

  • Chronic pain
  • Poor concentration and memory
  • Fatigue
  • Gait and balance problems
  • Headaches and migraines
  • Involuntary movements (shakes, tremors, jerks)
  • Paralysis and weakness
  • Non-epileptic seizures
  • Sensory changes
  • Sleep disturbances
  • Speech problems
  • Bladder and bowel changes
  • Visual impairments
  • Difficulties doing daily activities.

 

These symptoms are real and not imagined. You have no conscious control over them.

It’s common in FND for symptoms to come and go time to time.

 

Diagnosis and Treatment

 

Diagnosis can be made following physical examination and investigations to exclude any possible physical causes. This may be done by a psychiatrist or a neurologist.

 

Treatment involves psychotherapy, physiotherapy, and antidepressants. The options are variable and depends on the severity and individual circumstances of the patient.

 

For further support and information please book an appointment with our specialists….

 

To learn more about FND, please click on https://fndhope.org/fnd-guide/

 

Dr Ibrahim Yahli MD MRCPsych

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