Functional Neurological Disorder (FND)
FND is the most common neurological disorder you never knew about.
It is the second most common reason for a referral to a neurologist second only to migraine.
FND often presents rather rapidly, and does so in many different ways, including:
– Seizures
– Paraplegia or limb weakness
– Loss of sensation or feeling disconnected from a limb
– Chronic pain that moves unpredictably
– Blindness and vision problems
Diagnostic work up is usually a difficult and frightening experience, given the gravity of the symptoms, and the paradox of all imaging and blood tests coming back: normal.
If you have been diagnosed with FND it’s important to know this is not a diagnosis of exclusion.
There are rule in diagnostic criteria that a neurologist familiar with functional movement disorders can confidently and accurately diagnose with a lower misdiagnosis rate than other neurological conditions such as multiple sclerosis.
In FND often a metaphor of a computer is used to better explain what is happening: there is no problem with the physical computer or circuit boards, but with the software. Kind of like your nervous system needs a serious reboot.
Unfortunately this is not often explained well and patients are left feeling it is believed they are faking their symptoms, or that “it is all in your head”.
Connections to knowledgable and passionate healthcare professionals: psychologists, physiotherapists, occupational therapists, GPs and neurologists are also often difficult to find.
The very good and uplifting news:
FND is often reversible with the right rehabilitation approach and multidisciplinary team alongside.
This typically involves:
✅ A strong focus on regulating the nervous system (in physio this might look like learning more about and meeting your sensory needs and practising mindfulness in session)
✅️ Ensuring you are connected with a good psychologist if you do have underlying trauma which may need specialised care. Please note, a history of psychological trauma although common in people with FND, is not present in everyone.
✅ Re-establishing quietened neural pathways by targeting automatic functions of vision, balance, movement, and sensation with reduced cognitive load (in FND the more you actively *try* to do the thing you can no longer do, the harder it gets. So we do the opposite in rehab. Less trying, more play.)
✅ Ensuring you feel more in control of your rehab, safer in your body, and have tools for self management and fostering improvement longer term.
Catherine’s extended learning and support:
I am learning from leading FND specialists in Australia and have recently traveled to Brisbane to attend the 2025 FND Symposium
I’m now back and filled with enthusiasm to better help in my capacity as your physio.
Know you are not alone, and there are networks of professionals here to help and reach out to, even if the majority seem they are interstate or around the world.
If you are a health professional in Perth and interested in FND, please reach out! I’m hopeful to build a community of health professionals here in Perth WA to better support each other to in turn better support our clients.