I’ve been Diagnosed with Functional Neurological Disorder- What now?
What is Functional Neurological Disorder?
Functional Neurological Disorder (FND) is where brain networks malfunction without structural damage. It’s a disorder of connectivity, not tissue.
Once labelled as ‘hysteria’, FND has evolved into a neurobiological framework integrating psychology, neurology, and neuroscience. “Hysteria” (hystera = womb) was used to explain sudden paralysis, mutism, or seizures in women.
How Common is Functional Neurological Disorder?
FND accounts for 5-10% of new referrals to a neurologist. It’s the second most common reason after headache.
FND commonly affects women aged 20-50 but can occur in anyone, including children and the elderly.
Have you been diagnosed with Functional Neurological Disorder (FND)?
Book an assessment with a specialist neurological physiotherapist today
What can be done to Help?
Symptoms can be reversed with therapy. This is because the brain can be rewired again in an adaptive way. Treatment focuses on retraining the brain, not searching for damage.
The most important starting point for treatment is that someone understands their FND and how their brain is maintaining the symptoms.
Neurological Physiotherapy can target re-learning of patterns of movement and sensation, normally when someone is distracted so they are not hyper focusing on their symptoms. Over time control of their movements and bodily sensations is re-established.
Cognitive Behavioural Therapy (CBT) supports the brain over time to learn to make accurate predictions again, by focusing on ‘true’ sensory feedback, ignoring irrelevant information, and reducing the impact of fear and other emotions that hijack the brain. People are taught to detach from the symptoms and re-engage with activities in their lives.
What Causes Functional Neurological Disorder?
FND is caused by a combination of factors that will be specific to each person.
Low income, education, and social adversity increase the risk of FND, showing that environmental factors do affect the brain.
There may be slight changes in the brain due to genetics and fluctuations in hormones may also play a role in FND developing.
Having suffered from anxiety or depression, having issues with chronic pain or dizziness or suffering from trauma may have occurred before FND develops.
What Happens in the Brain of someone with Functional Neurological Disorder?
FND results from faulty communication between the emotional, motor, and salience networks in the brain, disrupting how things are perceived, the ability to prioritise important information and respond appropriately, and the ability to control bodily processes.
The brain likes to predict. When it over-relies on what it expects to occur, it can ignore real sensory feedback, producing symptoms.
Symptoms feel involuntary because self-monitoring circuits in the brain misfire.
Incorrect patterns of movement, sensation, and expectation are reinforced by repetition and being hyper focused on symptoms. The brain becomes rewired over time, but this is maladaptive. This results in symptoms persisting.
The brain ignores that it is making errors, and the ‘true’ sensory feedback available to it and therefore continues to “believe” its faulty predictions- that movement cannot occur, or sensation is abnormal.
This is also why symptoms vary so much from person to person, it all depends on what each person’s brain is choosing to focus on and ignore.
How Quickly will I Recover?
The longer someone has had FND, the longer it will take to treat, as the brain has become very used to behaving maladaptively. However, that doesn’t mean that recovery is not possible and the team at Neurological Physiotherapy will be there to support you the whole way through.
Additional information and advice can be found at: www.fndaction.org.uk
