What is Functional Neurological Disorder

Functional Neurological Disorder (aka FND) is a recognised neurological condition characterized by a wide array of symptoms that closely resemble those observed in structural neurological disorders. 

Extensive research and clinical evidence indicate that FND is a genuine neurological condition, not consciously produced by the individual. Unlike structural abnormalities that can be detected through imaging techniques, FND does not exhibit consistent structural changes in the nervous system. However, this does not diminish its neurological nature.s.

FND is believed to arise from underlying neurological dysfunction that is not visibly apparent through structural imaging. The presence of objective neurological symptoms, such as paralysis, tremors, seizures, and sensory disturbances, further underscores the involuntary nature of these symptoms. Individuals with FND do not consciously produce or fabricate these symptoms, as they often occur spontaneously and are inconsistent or incongruent with known anatomical pathways. This neurological basis of FND is supported by studies utilising functional brain imaging, which have revealed altered patterns of brain activity and connectivity in affected individuals.

A recent article in the scientific america journal discussed that some health professionals are looking at FND and symptoms as not being genuine. Further information can found regarding the article here. Whilst more research needs to be conducted in this area, it is important that individuals with FND have their symptoms addressed, assessed and managed. Practitioners at Allied Health 2U, which include mobile occupational therapists, mobile physiotherapists have the ability to complete suitable functional capacity assessments for individuals with FND.

Who does Functional Neurological Disorder affect?

FND can affect individuals of any age or gender, although it is more commonly diagnosed in young to middle-aged women. It is recognized as one of the most common conditions encountered by neurologists, with a prevalence comparable to or even higher than other neurological disorders like multiple sclerosis or Parkinson’s disease.

Despite its widespread occurrence, FND has historically faced challenges in recognition and diagnosis due to its complex and varied presentations. However, efforts to increase awareness and understanding of FND have led to improved recognition and diagnosis in recent years.

Regardless of age or gender, it is crucial to continue research, education, and support to address the challenges faced by individuals living with FND and ensure appropriate care for all affected individuals.

How can we assist someone with Functional Neurological Disorder?

Assisting someone with FND involves providing empathetic and compassionate care. Creating a safe and inclusive environment where individuals feel validated and heard is crucial. This can be achieved through understanding the real nature of their symptoms and acknowledging their impact. A multidisciplinary approach is essential, involving neurologists, psychiatrists, Occupational Therapists psychologists, physiotherapists, and other specialists. Psychoeducation, medication, Occupational therapy, psychotherapy, and physiotherapy play significant roles in managing FND.

At Allied Health 2U, we have a number of suitable professional who are able to assist in fully appreciating someone function with FND. As individuals with FND can have variable function and can present differently, it is important that each individual is assessed separately according to their needs. Just some of the allied health professional who can assist include:

• • Occupational Therapists can assist in completing both functional assessment from a physical and psychosocial perspective. 

• • Physiotherapists can provide a pivotal role in progressing physical function

• • Counsellors/ psychotherapists can provide the psychosocial supports

• • Psychologists can provide mental health support

• • Exercises physiologists can progress individuals exercises. 

• • Behaviour Support Practitioners, where an individual with FND has behaviours of concern which could result in harm to themselves or others beahviours support practitioners would assist in implementing suitable positive behaviour strategies to assist the individual. 

Psychoeducation provides information and empowerment, medication addresses specific symptoms or comorbid conditions, psychotherapy helps develop coping strategies, and physiotherapy improves physical functioning. Support groups and patient advocacy organizations can also provide valuable resources and a sense of community. By combining empathy, education, and multidisciplinary care, we can effectively assist individuals with FND and improve their quality of life.

What equipment may someone with FND require?

The equipment requirements for individuals with FND can vary depending on their specific symptoms and functional limitations.

Some individuals may benefit from mobility aids such as wheelchairs, walkers, or canes to assist with challenges in walking or balance. Communication devices, including speech-to-text software or alternative communication devices, can be helpful for individuals experiencing speech difficulties. Adaptive utensils or assistive devices for eating and drinking may aid those with motor control issues. Additionally, specialised equipment can be beneficial for managing sensory disturbances, such as weighted blankets or noise-canceling headphones.

It is important to consult with healthcare professionals, such as occupational therapists or assistive technology specialists, to assess individual needs and provide recommendations for appropriate equipment that can enhance independence and improve daily functioning for individuals with FND.

What assessments are required to assess someone with FND?

Assessing someone with FND Requires a comprehensive evaluation process that encompasses multiple assessments. This includes neurological examinations to rule out structural abnormalities, diagnostic criteria to confirm FND diagnosis, medical history and interviews to gather information about symptom onset and impact, brain imaging to exclude structural abnormalities, psychological assessments to evaluate mental health and cognitive functions, electrophysiological tests to assess electrical activity in muscles or the brain, and functional tests to observe symptom response. These assessments provide a holistic understanding of the individual’s symptoms, functional limitations, and contributing factors, enabling healthcare professionals to make an accurate diagnosis and develop appropriate management strategies for FND.