Are you experiencing various physical difficulties? Maybe you suddenly can't walk, your limbs tremble, you have seizures, or you have difficulty speaking. But when you see many doctors, have tests and even scans, they all say that you are not sick? Are you feeling very depressed because of this? No one understands your problem, do others think you are acting? If so, don't worry. You are not alone. Today we are talking about a condition that many people who face similar experiences may have, but it is difficult to diagnose. That is Functional Neurological Disorder, or FND for short.
Simply put, what is FND (Functional Neurological Disorder)?
Think of your brain as the hardware of a computer. The nervous system is like the wires that connect to that computer. Both of these work perfectly. That means if you do a CT scan or an MRI scan, there's nothing wrong with your brain. Everything is healthy.
So where is the problem?
The problem is in the software running on the computer. That is, there is a small glitch in the messaging system that carries information between the brain and the body. The messages that the brain sends to the body, and the messages that the body receives from the brain, are not exchanged properly. Just like when the phone signal is lost, the call is broken and sounds distorted. Because of this signal glitch, your body actually starts to show symptoms.
These are real symptoms. You're not imagining them. But because an outsider can't see the reason for this, they might think you're just faking it. This can be a very painful experience for you.
This used to be called Conversion Disorder. Why did the name change?
In the past, doctors thought that this was a purely psychological problem. That is, they thought that things like stress, sadness, and traumatic experiences were "converted" into physical symptoms. That's why it used to be called ``Conversion Disorder.''
But new research has now found that it is more complex than that. Special scans, such as functional MRI (fMRI), show changes in the brain activity of people with FND. Also, not everyone with FND has had a traumatic event or a traumatic brain injury. Therefore, the old name is no longer used.
What symptoms might someone with FND experience?
FND symptoms usually come on suddenly. They can also interfere with your daily activities. Sometimes, the symptoms may get worse when you think about them, or they may go away when you focus on something else.
Here are some of the most common symptoms of this condition.
| Symptom category | Description and examples |
|---|---|
| Seizure-like states (PNES) | These may look like epilepsy. There may be convulsions and loss of consciousness. However, the brain test (Electroencephalogram - EEG) reports normal. These are called (Psychogenic Non-Epileptic Seizures - PNES) . |
| Problems related to body movement | Tremors, body shaking, difficulty walking, and loss of body control. These things feel like they're happening out of your control. |
| Problems related to the five senses | Problems with vision, hearing, smell, taste, and touch. For example, there may be sudden blurred vision, double vision, decreased hearing, or numbness in parts of the body. |
| Problems with thinking and memory | Brain fog, suddenly forgetting what you were going to say while talking, forgetting words, forgetting where you put important things. It can also be difficult to stay focused. |
| Dizziness and balance | Feeling like you are floating in a boat, rather than feeling dizzy. You may lose your balance while standing. |
| Pain | Body aches, sharp stabbing pains, burning sensations. This pain can be constant or come and go. Migraines can also occur frequently. |
In addition, you can also see these features:
- Constant feeling of extreme fatigue and lack of energy.
- Difficulty speaking or stuttering .
- Conditions such as muscle weakness or paralysis.
- Difficulty swallowing something.
Why does FND develop? What are the factors that affect it?
Doctors still don't know exactly what causes FND. But we do know that it's caused by a problem with the way messages are sent between the brain and the body. Using the same computer example we discussed earlier, the hardware and wiring are all fine, but there's a small "glitch" in the software.
This defect changes the way the brain sends and receives messages. In other words, the brain is running a "wrong program." Treatment involves removing this wrong program and "retraining" the brain and nervous system so that messages can flow properly again.
The important thing is, nothing in your body is "broken" or "irreparably damaged." The problem is just the function.
Triggers for FND symptoms
Some events or situations can cause FND symptoms to appear suddenly.
- Various infectious conditions
- Migraines
- Physical accidents or injuries
- Severe stress or traumatic events
Sometimes, after a trigger like this, the brain can "get stuck" on that symptom, like a ruptured disc spinning in the same place. Experts believe this pattern can lead to FND.
How do doctors diagnose FND?
Diagnosing FND is a bit of a complicated process, as the symptoms are similar to those of many other neurological conditions, making it difficult to tell the two apart.
You may have to see many doctors and have many tests. This can be a very tiring and frustrating journey. Some may even tell you that your illness is "all in your mind." But your doctor will reassure you that your symptoms are real and that you are doing the right thing.
Typically, a multidisciplinary team, including neurologists, psychiatrists, and physical therapists, works together to diagnose FND.
Diagnostic tests
Depending on your symptoms, your doctor may order tests like these:
- Blood tests
- CT scan
- EEG test
- Electromyogram (a test that measures muscle activity)
- Functional MRI (fMRI)
- A complete neurological exam
All of these tests are done to rule out other physical conditions that could be causing your symptoms (e.g., epilepsy, multiple sclerosis). If all of the test results are normal and your symptoms are consistent with FND, your doctor can confirm the diagnosis of FND.
What are the treatments for FND?
Because FND is a complex condition, it cannot be cured with a single drug. It is treated by combining various treatments. The main goal is to restore the signaling system between the brain and the body.
| Treatment method | What happens? |
|---|---|
| Physical Therapy | This is very important for people with movement problems (difficulty walking, tremors). What you are doing here is retraining the brain to the correct movement patterns. In other words, it is like removing the wrong software program and installing the right one. |
| Occupational Therapy | Helping to do daily tasks (e.g., dressing, cooking) independently again. |
| Speech Therapy | Treatment for speech or swallowing difficulties. |
| Cognitive Behavioral Therapy (CBT) | It helps you understand how your thoughts, feelings, and behaviors are connected. This can help you identify and manage thought patterns that exacerbate symptoms. |
| Medication | There is no specific treatment for FND. However, if you have other conditions, such as depression, anxiety, or chronic pain, your doctor may prescribe medication to treat them. |
Can you have hope while living with FND?
It's definitely possible. FND is not a life-threatening disease. However, it can have a significant impact on your quality of life.
Recovery is not the same for everyone. Some people recover quickly. Others take time. Sometimes symptoms may improve and then recur. That's part of the journey. It doesn't mean you've failed.
The following are important for successful results:
- Getting an accurate diagnosis as soon as possible.
- Building a good relationship with your doctor and treatment team .
- Identify and manage the stressors that trigger symptoms.
- Start treatment soon .
Remember, you need strength to go through this journey. But the fact that you've come this far shows how strong you are. You don't have to solve everything at once. Even if it's a small step, it's part of the healing journey.
Take-Home Message
- FND is a real problem with the way the brain communicates with the body. It's not "just in your head."
- Your symptoms, that is, the physical discomforts you feel, are 100% real. Just because your test reports are normal doesn't mean you don't have the disease.
- It can take time to get the right diagnosis, but don't give up. It's important to see the right doctor.
- Treatment involves retraining the brain. Things like physical therapy and psychotherapy are very important for this.
- Healing doesn't happen overnight, it's a process. There will be good days and bad days. But keep moving forward with hope.
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