Understanding Functional Neurological Disorders (FND)

Functional neurological disorders (FND) encompass a range of nervous system symptoms that lack an apparent neurological disease or medical explanation. Previously referred to as conversion disorders, FND presents real and distressing symptoms that can significantly impact daily life.

What are the Symptoms of Functional Neurological Disorders (FND)?

FND symptoms vary based on the type, often impacting movement or senses like walking, swallowing, seeing, or hearing. The severity of these symptoms can fluctuate, appearing and disappearing or persisting over time. Importantly, these symptoms are not under conscious control. They can disrupt both physical movement and sensory experiences.

Impact on Movement and Function:

• Muscle weakness or paralysis
• Unusual movements like tremors or difficulty walking
• Impaired balance
• Trouble swallowing or sensing a "lump in the throat"

Episodes of shaking and seeming unconsciousness (non-epileptic seizures)

• Periods of unresponsiveness
• Impact on Sensory Perception:
• Numbness or decreased sense of touch

Speech difficulties, such as an inability to speak or unclear speech

• Visual disturbances like double vision or loss of sight
• Hearing problems or deafness
• Cognitive challenges affecting memory and focus

What Causes FND?

The exact cause of functional neurological disorders remains elusive. Potential triggers may include neurological disorders, stress, psychological trauma, or physical injury, although these factors aren't always present. FND is believed to be linked to brain function rather than structural damage, differentiating it from conditions like stroke, multiple sclerosis, infections, or injuries. Theories about the underlying brain mechanisms responsible for symptoms are intricate, involving various processes that may differ depending on the specific FND type. Brain regions governing muscle and sensory functions might be implicated, even without detectable disease or abnormality.

Potential Triggers and Causes of FND:

Stressful Events: Symptoms may appear suddenly after experiencing a stressful situation.

Emotional or Physical Trauma: Trauma can also act as a trigger for FND symptoms.

Brain Function Disruptions: Alterations or disruptions in brain function at the structural, cellular, or metabolic level might contribute.

Difficulty in Identifying the Trigger: Sometimes, the exact cause behind the onset of symptoms remains unclear.

Multifactorial Nature: The precise cause of FND is unknown, but it's likely a combination of factors, including:

• Stress
• Trauma
• Neurological disorders
• Mental health conditions like anxiety or depression

Who is at Risk for FND?

People with a history of the following are at higher risk for FND:

Pre-existing Neurological Conditions: Conditions like epilepsy, migraines, or movement disorders can increase the risk.

Recent Stress or Trauma: Experiencing significant stress, emotional trauma, or physical injury can be a contributing factor.

Mental Health Conditions: Mood disorders, anxiety disorders, dissociative disorders, or certain personality disorders can elevate the risk.

Family History: Having a family member with a neurological or psychiatric condition or symptoms might increase susceptibility.

History of Abuse or Neglect: Childhood experiences of physical or sexual abuse or neglect by a caregiver can be a risk factor.

Gender: Women might be more prone to developing FND compared to men.

Potential Challenges Associated with FND

If left untreated, specific FND symptoms can lead to significant limitations and reduced quality of life, mirroring the impact of physical illnesses. FND may also be linked to:

• Chronic pain
• Anxiety disorders, including panic disorder
• Depression
• Sleep difficulties, like insomnia
• Persistent fatigue

Diagnosing Functional Neurological Disorder

There's no single, definitive test for FND. Diagnosis typically involves a comprehensive assessment of your current symptoms and ruling out any potential neurological or medical conditions that might be causing them. The diagnosis hinges on the presence of specific patterns of signs and symptoms rather than the absence of structural changes on an MRI or abnormalities on an EEG. Both neurologists and mental health professionals, like psychiatrists, may be involved in the testing and diagnosis process.

Evaluation Process:

Physical Examination: A thorough medical evaluation will be performed, including a physical examination and an in-depth discussion about your medical background and current symptoms. Testing might be necessary to eliminate other potential medical causes.

Psychiatric Examination: Your neurologist might refer you to a mental health professional if needed. They'll inquire about your thoughts, feelings, and behaviours and discuss your symptoms in detail. With your consent, they might also gather information from family members or others close to you.

DSM-5 Criteria: Your healthcare professional may assess your symptoms using the criteria established in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

DSM-5 Criteria for Conversion Disorder (Functional Neurological Symptom Disorder):

One or more symptoms affecting movement or senses.

Symptoms cause significant distress or problems in social, work, or other areas or warrant medical evaluation.

Symptoms can't be explained by a neurological or other medical condition or a separate mental health disorder.

How is FND Treated?

Treatment for FND is tailored to your specific symptoms and may involve a multidisciplinary team, including neurologists, mental health professionals, and speech, physical, and occupational therapists. Recognizing FND as a condition with treatable symptoms can empower you in your treatment journey. Education and reassurance from your healthcare provider that your symptoms aren't due to a severe underlying medical issue can lead to improvement. For some, this education and reassurance alone are the most effective treatment. Others may benefit from additional therapies. Involving loved ones in understanding and supporting your journey can also be helpful.

Addressing Underlying Medical Conditions: Your medical team will address any existing neurological or other medical conditions that might trigger your symptoms.

Therapies:

Physical or Occupational Therapy: Collaborating with therapists can enhance movement, prevent complications, and improve overall function.

Speech Therapy: A speech therapist can provide valuable assistance if you have speech or swallowing difficulties.

Stress Reduction and Distraction Techniques: Techniques like progressive muscle relaxation, breathing exercises, and physical activity can help manage stress. Distraction methods can also be beneficial, such as music, conversation, or intentionally changing movement patterns.

Mental Health Options: While FND symptoms aren't solely psychological, emotions and thought patterns can influence your symptoms and recovery.

Cognitive Behavioral Therapy (CBT): CBT helps identify and address negative thought patterns, promoting healthier coping mechanisms and stress management. It can be beneficial for those experiencing non-epileptic seizures. Other psychotherapy approaches might be helpful if you're dealing with interpersonal challenges or a history of trauma or abuse.

Treating Coexisting Mental Health Conditions: Conditions like depression, anxiety, or other mental health disorders can exacerbate FND symptoms. Addressing these alongside FND can significantly improve recovery.

Medications: While no specific medications are FDA-approved for FND, antidepressants might be beneficial if you also have depression, mood disorders, pain, or insomnia and should be taken under the guidance of healthcare professionals.

Regular Follow-up: Consistent follow-up with your medical team is vital to monitor your progress and adjust your treatment plan as needed.

Sterling Hospital: Your Partner in Health Across Gujarat

Consult a doctor if you experience any symptoms that worry you or hinder your daily activities. Early identification of the underlying cause and timely intervention are essential, mainly when the origin lies in a neurological disorder or other medical issue. Even with a diagnosis of functional neurological disorder, treatment can alleviate symptoms and prevent future complications. At Sterling Hospital, we provide the utmost care and comfort throughout your journey to a healthier and brighter life. Whether you're looking for the best neurologist in Ahmedabad-Gurukul, Vadodara-Race Course Road, Vadodara-Bhayli, Rajkot, or Gandhidham, we have a team of the best neurologists with considerable years of experience. We are committed to providing premium treatment and achieving the best results.

Contact Sterling Hospital to schedule a consultation and embark on a journey towards a healthier future.