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What is FND

Understanding Functional Neurological Disorder (FND)

Functional neurological symptoms (FNS) or Functional Neurological Disorder (FND) is an umbrella term for a wide spectrum of sensorimotor symptoms that resemble neurological conditions.

FND includes functional movement disorders and tremors, idiopathic non-epileptic seizures, drop-attacks, visual symptoms such as blindness, photophobia and double vision, speech impairment and stutter, touch sensitivity, chronic pain, gate and balance problems, as well as paralysis and weakness.

Cognitive and emotional challenges, memory loss, brain fog, fatigue, anxiety, or avoidance often accompany FND. In addition, symptoms of altered awareness, including dissociative symptoms, derealization, and depersonalization, are very common.

Individuals experiencing FND are often semi-conscious and clients have described that they can hear what is being said, but that they cannot speak, feel foggy, out-of-their-body, numb, or overtaken by a strong energy. Anxiety, depression, symptoms of PTSD, and difficulty concentrating often accompany FND.

Watch Dr. Moenter’s contribution to the 2020 FND virtual conference talking about her treatment approach to FND.

Watch Dr. Moenter’s contribution to the 2023 FND & Me Virtual Workshop for Teens with FND.

How is FND diagnosed?

The diagnostic process relies on finding clear positive physical features of the condition which makes FND not a diagnosis of exclusion. Due to similarities, FND can be misdiagnosed as a neurological disorder, and it can take years for the patient to find out that he, she, or they does not actually have a neurological disorder. FND has been diagnosed in children, teenagers, and adults.

FND and the Nervous System

As part of Dr. Moenter’s somatic-based approach to working with functional neurological symptoms, she divides symptoms into two categories, those of a hyper-activated nervous system (such as NES, twitches, jerks, pain etc.) and those of a hypo-activated nervous system (such as paralysis, drop-attacks, limp weakness etc.).

The Causes of FND

Contrary to popular belief, anybody can experience the sudden onset of FND. Age, gender, mental health, level of education, or other demographic factors seem to not have direct bearing on the onset of FND.

Research suggests that an existing chronic illness such as MS or Parkinson’s, and/or accumulated stress and trauma in a person’s life can lead to the development of FND. Reports show that approximately 70% of individuals with FND have been exposed to accumulated stress and/or trauma during their life. Underlying conditions are in many cases depression (50-90% of individuals with FND are also clinically depressed), post-traumatic stress disorder (25-58% of individuals are diagnosed with PTSD), and/or anxiety disorders (about 50% of individuals with FND). In a sense, functional neurological symptoms can be seen as a physical manifestation of a dysregulated nervous system.

Some correlation exists between not only PTSD and FND, but also between being “highly sensitive” and FND. A highly sensitive person is an individual who has sensory processing difficulties, including hypersensitivity to external stimuli, a greater depth of cognitive processing, and high emotional reactivity.