Functional Neurological Disorders

Functional Neurological Disorders

Functional Neurological Disorder (FND) is a condition where the brain has difficulty sending and receiving signals properly, causing problems with movement or other neurological functions, like sensation, speech, or even vision. Despite these symptoms, medical tests often show no clear cause, meaning the issue is not related to structural damage to the brain or nervous system. Essentially, the brain and body aren’t working together in the usual way, which can lead to physical and psychological symptoms.

In simple terms, FND is a disorder where the brain “malfunctions,” leading to problems with how the body moves or functions, without an obvious physical injury or disease.

Common Clinical Signs of FND:

1. Movement Problems:

  • Tremors or shaking
  • Weakness or paralysis in parts of the body, such as the arms or legs
  • Abnormal gait or difficulty walking (e.g., dragging a foot or having a stiff walk)
  • Spasms or muscle tightness

2. Sensory Issues:

  • Numbness or loss of feeling in certain areas, like hands, arms, or legs
  • Blurry vision or double vision
  • Dizziness or feeling off-balance

3. Non-Epileptic Seizures (NES):

  • Seizure-like episodes that don’t have the typical electrical patterns seen in epilepsy; they can involve shaking, collapsing, or altered awareness.

4. Speech and Swallowing Problems:

  • Difficulty speaking clearly or articulating words
  • Trouble swallowing or a feeling of a “lump in the throat”

5. Fatigue and Cognitive Issues:

  • Memory difficulties or trouble concentrating
  • Feeling extremely fatigued despite adequate rest

FND can be distressing because the symptoms are real but don’t show up on most medical scans or tests. It’s important to note that it is not “all in the head”—it’s a complex condition that requires a multidisciplinary approach, including physiotherapy, psychological support, and sometimes medications.

As a physiotherapist with over 10 years of experience in treating patients with Functional Neurological Disorders (FND), I’ve seen firsthand how challenging these conditions can be. FND manifests as neurological symptoms, such as paralysis, tremors, or seizures, that don’t have an identifiable medical cause. While this can be frustrating and distressing for patients, physiotherapy plays a crucial role in helping manage symptoms and improving quality of life.

Distraction Strategies

One of the most effective techniques in managing FND is using distraction strategies. FND symptoms often worsen during stress or anxiety, so finding ways to divert focus can help prevent symptom flare-ups. Techniques like deep breathing, mindfulness, or focusing on simple physical tasks can redirect attention away from the symptom. Activities like engaging in hobbies, listening to music, or visualizing calming imagery can significantly reduce symptom intensity by breaking the cycle of tension and anxiety.

Recognizing Warning Signs and Triggers

Another key aspect of managing FND is identifying and understanding the warning signs or triggers that may precipitate an episode. This could include physical stress, emotional triggers, or environmental factors. By keeping a symptom diary, patients can work with their physiotherapist to pinpoint patterns and develop strategies to address these triggers.

In my experience, a personalized, patient-centric approach is vital. Through consistent therapy, education, and awareness, we can empower patients to better manage FND and lead a more fulfilling life.

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