Functional Neurological Disorder (FND)
FND is one of the commonest reasons for people to be referred to a neurologist. Despite this, it is often difficult for people to get a clear diagnosis, and when they do, it is often explained in a way that makes little sense. Unfortunately, the explanation sometimes makes the person feel as though the symptoms are imagined or put on. FND is a common cause of neurological symptoms which is real and genuine. Symptoms can be very diverse and can affect movement, sensation and cognitive function (thinking). Some people have persistent symptoms while others have attacks of symptoms which can, in some people, resemble epileptic seizures (these are usually called non-epileptic attacks or dissociative seizures). Chronic pain and fatigue are common associated symptoms.
One way of thinking about FND is that it is a problem with the way in which a person can access or control their body normally. The 'basic wiring' of the nervous system is intact which means that there is no irreversible lesion in the system that would completely prevent recovery. Having said this, people with FND often continue to have difficult symptoms, but access to the right treatment can make a real difference.
People with FND have higher rates of previous mental health problems than others, though these are by no means present in everyone. The experience of having FND, just like all of the other neurological illnesses, can often trigger changes in mood such as depression and anxiety. FND commonly happens in the context of illnesses, injuries and accidents, and sometimes there are ongoing direct effects of these problems which also add to symptoms.
The key to improvement and recovery from FND is a good, holistic understanding of the diagnosis and all the different aspects of symptoms that are occurring. It is with this understanding that bespoke treatment can be developed which uses specific techniques from physical and psychological rehabilitation therapies.