Treatment

Treatment for FND should be tailored to each individual, based on their specific symptoms, needs, and goals. Whilst no two experiences of FND are the same, research shows that outcomes improve significantly when care is based on early diagnosis, a clear explanation, and timely access to the right therapies.

Best practice involves a multidisciplinary team (MDT) led by a neurologist, working alongside physiotherapists, psychologists, occupational therapists, and others where needed.

FND Action strongly advocate for the need for collaborative care to be available and accessible, so that everyone diagnosed with FND has the best chance of recovery or effective symptom management.

Collaborative Treatment for FND

FND treatment is most effective when it takes a collaborative, multidisciplinary approach. This means care should be coordinated across a range of professionals who understand the condition and how to support recovery. The central goal is to help individuals retrain brain-body pathways, manage symptoms, and improve quality of life.

Below, we outline the key roles in a high-quality FND treatment pathway, many of which should work together within a multidisciplinary team.

Neurology

Neurologists are responsible for leading the diagnostic process for FND, using positive clinical signs to confidently identify the condition. A clear explanation from a neurologist is crucial in helping patients understand their diagnosis and feel validated.

Although neurologists may not always oversee ongoing treatment, they remain essential in coordinating care and referring patients to specialist FND teams when available, or to neurorehabilitation services.

People experience different levels of recovery, and some may not require continued regular neurology appointments. However, it is important that patients retain open access to neurology services to ensure rapid reassessment and support if symptoms change or new challenges arise.

Neuropsychiatry / Neuropsychology

These specialists play a crucial role in assessing cognitive function such as attention, memory, and processing speed, which can be affected in some people with FND. Neuropsychologists often carry out detailed cognitive assessments and support rehabilitation where needed.

Additionally, they help explain how stress, emotion, trauma, and perception could influence symptoms for some people, tailoring interventions accordingly and supporting the management of symptoms. Therapies that may be considered include CBT, EMDR and other talking therapies.

Neuro-Physiotherapy

Therapy focuses on retraining movement and motor control. This is particularly useful for those experiencing functional weakness, tremors, dystonia, and gait (walking) difficulties. Therapy may include task-specific movement retraining, techniques to break maladaptive movement patterns, and education on symptom mechanisms.

📄 Physiotherapy consensus recommendations paper

Occupational Therapy

Occupational therapists support people in their daily lives, helping them adapt environments, routines, or activities to reduce symptoms and increase independence. They may provide support in adaptions for mobility issues or fatigue, energy conservation techniques, and support with returning to work or education.

📄 Occupational therapy consensus recommendations paper

Other Therapies

In addition to core treatments led by neurology, neuropsychology, and rehabilitation teams, some people may benefit from specialist therapies tailored to their specific symptoms. These therapies address areas not covered by the main disciplines but are important for comprehensive, patient-centred care. Examples include:

Speech and Language Therapy (SLT): Supporting individuals with functional speech, voice, or swallowing difficulties. SLT interventions focus on improving communication skills and addressing challenges related to swallowing.
📄 Speech and language therapy consensus recommendations paper
Pain Management: Addressing chronic pain, which can co-occur with FND symptoms, through multidisciplinary approaches.
Fatigue Management: Specialist input may be needed to address severe fatigue, helping patients balance activity and rest effectively.

Social Care

FND can affect employment, relationships, and independent living. Social care professionals may help with accessing disability benefits, personal care support, and liaise with housing and social services. A good social care response helps reduce isolation and practical barriers, especially for those with long-term or severe symptoms.

📍 Official Clinical Pathways for FND – England & Scotland

There are formal NHS-endorsed clinical pathways that explain how FND should be diagnosed and treated. These are important tools for both clinicians and patients:

Highlighting These Pathways Is Essential – they help validate the diagnosis and guide appropriate care.

📄 England – Optimum clinical pathway for adults: Functional Neurological Disorder ▪ Emphasises early diagnosis based on positive signs, access to coordinated care, and specialist therapy.

📄 Scotland – NHS Functional Neurological Disorder National Pathway ▪ Describes a consistent, multi-professional model of support for people with FND.

These can be shown to GPs, neurologists, or commissioners when requesting appropriate care.

Additional Treatments and Ongoing Care

Effective care for FND doesn’t stop with initial treatment. Many people benefit from a combination of medical support, practical self-management tools, and a responsive, long-term care plan. This section outlines further aspects that can support recovery and wellbeing.

Medication

Medication can be helpful in managing co-existing symptoms such as pain, sleep disturbances, anxiety, or low mood. However, there is currently no medication that treats FND itself. Any prescription should be considered as part of a wider, personalised treatment plan.

Self-Management Strategies

Many people with FND find that learning strategies to manage symptoms, or symptoms triggers, day to day can support their recovery and sense of control. These may include:

Pacing: Balancing activity and rest to prevent symptom flare-ups.
Grounding techniques: Useful for managing dissociation, sensory overload, or anxiety.
Education: Understanding the condition can help reduce fear and uncertainty.
Support networks: Peer support can provide encouragement, reduce isolation, and offer practical advice.

Consideration of Comorbidities

FND can exist alongside other conditions. Having one diagnosis doesn’t rule out others, and identifying comorbidities is essential for accurate diagnosis and effective treatment. These might include:

Other neurological conditions.
Mental health problems (e.g. anxiety, trauma, depression).
Nutritional deficiencies (e.g. B12).
Medication side effects.

Comorbidities can influence how symptoms present and respond to treatment. A thorough, well-rounded assessment supports more accurate care planning and better outcomes.

Alternative and Complementary Approaches

Some individuals with FND find additional benefit in exploring complementary therapies. These may help with symptom regulation, relaxation, or wellbeing, but should always be considered alongside – not instead of – evidence-based care. Examples include acupuncture, yoga, or mindfulness-based practices. It’s encouraged to consult with a healthcare professional before beginning any complementary therapy.

Current Reality for Many People

Although effective treatment pathways for FND are increasingly recognised, the reality for many people remains far from ideal. Common challenges include:

Long waiting times.
Limited or non-existent local services.
Clinicians unfamiliar with FND or lacking confidence in managing it.
People being discharged without clear follow-up or ongoing support.

This has created a “postcode lottery” effect. Whilst some people receive joined-up, informed care, many are left to navigate symptoms alone. Or worse, feel dismissed, disbelieved, or blamed.

Emerging and Investigational Approaches

Research into FND treatment is ongoing, and several innovative approaches are being explored. These include:

Virtual reality (VR) and neurofeedback to support retraining brain-body connections.
App-based therapies for symptom tracking, pacing, or grounding exercises.
Wearable technology to monitor movement or physiological responses.
Online and remote therapy platforms increasing access to specialist care.

While these approaches are not yet part of routine NHS care, they may offer promising tools in the future.

FND Action advocate that everyone diagnosed with Functional Neurological Disorder should have their health managed by a consistent primary care provider whilst symptomatic.

This provider should work collaboratively with other professionals to support care, in line with the NICE Quality Standard QS198 on suspected neurological conditions and the Patient Experience in Adult NHS Services (QS15) – both of which highlight the importance of coordinated, respectful, and timely care.

The Functional Neurological Disorder Society (FNDS) was established by leading international specialists to support and connect medical professionals involved in the care of people with functional neurological symptoms.

To learn more or to become a member, visit www.fndsociety.org.

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