What is Functional Neurological Disorder

Functional Neurological Disorder (FND) is a brain disorder that can encompass a diverse range of neurological symptoms including limb weakness, paralysis, seizures, walking difficulties, spasms, twitching, sensory issues and more. 

Whilst the symptoms may appear similar to those seen in neurological conditions such as Multiple Sclerosis, Parkinson’s and Epilepsy, and can be just as debilitating, they have a different underlining cause. 

The basic wiring of the nervous system is intact, but there is a problem with how the brain/nervous system is “functioning”, and how the brain fails to send and receive signals/messages correctly. This impacts on how the body responds to different tasks such as movement control and attention.

Functional Neurological Disorder is often explained to patients as a psychological reaction due to past trauma, or as symptoms due to stress. These explanations usually fail and result in patients feeling alienated, stigmatised and not-believed. The main reason for the failure of such explanations is that they take a potential risk factor and turn it into the cause of the problem.[1]

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A diagnosis is made by a Neurologist from positive neurological signs and tests that are specific to Functional Neurological Disorders. The Hoovers Sign, for example, is a specific test in relation to limb weakness. It is important a positive diagnosis is reached to avoid misdiagnosis, and that consideration is given to the fact that FND may also present alongside other Neurological diseases.

Functional neurological symptoms are commonly seen in Neurology and Epilepsy clinics, and in pediatric care. Studies suggest symptoms are the second most common reason for an initial Neurology appointment, after headaches/migraines that require further investigation. Symptoms are sometimes referred to as Medically Unexplained (MUS). This is inappropriate given it is known that there is a problem with how the nervous system is functioning, so being referred to in this way is misleading for those diagnosed and clinicians.

Current understanding is that biological, psychological and social factors may contribute towards a person’s vulnerability to developing a Functional Neurological Disorder. Research continues to ascertain a clearer picture of the causes and mechanisms.

To learn more about Functional Neurological Disorder please visit the neurosymptoms website which is a key medical information resource in the UK and worldwide, and is managed by a leading specialist in this field.


[1]  Cock HR, Edwards MJ.  Functional neurological disorders: acute presentations and management Clin Med (Lond). 2018;18(5):414–417. doi:10.7861/clinmedicine.18-5-414

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