Functional Neurological Disorder

What is Functional Neurological Disorder (FND)? 

FND is a health condition where your nervous system is not sending the right signals between your brain and your body leading the body to experience a range of physical symptoms.  

What Causes FND? 

It is not fully known why some kids develop FND. However, we do know that FND is a complex condition involving multiple areas of the brain, including the parts of the brain that control emotion regulation and motor movements.   

A wide range of individual factors can also affect your FND symptoms. These can include:  

• Psychological factors (anxiety, depression, medical history, etc.)
• Life stressors (stress at school, family stress, problems with friends and peers, etc.) 

What are the Signs & Symptoms of FND? 

Symptoms of FND are commonly associated with neurological conditions. But, with an FND diagnosis, you will see or experience symptoms without neurological disease or damage. The symptoms instead are caused by the disconnect between the brain and the body through the nervous system. Someone with FND is really experiencing symptoms, but the symptoms are not dangerous or damaging. 

FND can show up in your body in many different ways, with a variety of signs and symptoms. Some of the most common signs and symptoms include: 

• Abnormal control of movements, like:
  • Weakness
  • Tremors (like shaking or trembling)
  • Repetitive muscle movements that do not usually happen
• Changes in how you walk or hold your limbs
• Changes to how your senses pick up cues
  • Vision – like blurred vision
  • Hearing – like hearing a ringing noise
  • Skin sensations – like feeling as if your skin is twitching
• Generalized limb shaking that is not typical
• Brief loss of awareness 

How is FND Diagnosed?  

FND is diagnosed when we know your physical symptoms are not because of a neurological disease or damage. We figure this out by looking at medical history and any results from the physical exam/evaluation. A physician, such as a neurologist, will be the person who makes this diagnosis.  

How is FND Treated? 

FND is common and treatable. Learning about what FND is and understanding what is happening in your body can be the beginning of feeling better. Treatment is focused on helping you return to your typical activities and getting tools to manage and reduce symptoms. Treatment plans often include:   

• Psychotherapy and psychiatric care, which can include:
  • Cognitive-Behavioral Therapy (CBT)
  • Relaxation techniques
  • Coping skills
  • Family support, and maybe family therapy
  • Treating any mental health symptoms that may be happening at the same time, such as anxiety and depression
• Rehabilitation therapies, like:
  • Physical therapy
  • Occupational therapy
  • Speech therapy
  • Pain management (this may or may not include medication) 

Additional ways to help treat FND can include:

• Communicating with the primary care doctor and having regular visits that keep you healthy (instead of only when something is wrong). 
• Creating a plan to go back to normal activities and functioning, including slowly going back to school. Returning to typical activities and school can help you feel better.  
• Your Lurie Children’s healthcare team will work with you to create functional goals, coordinate communications with outpatient providers, and continue to help treat your child’s symptoms.
• We will also help you understand how to self-monitor symptoms and when to call the primary care doctor or mental health provider. 

Who is Part of the Treatment Team?  

As you can see above, there are many different treatment options. This means there are different providers who may be part of your treatment team. Depending on your specific needs, they may see healthcare professionals such as psychologists, physical therapists, occupational therapists, neurologists, and others. 

Do People Recover From FND? 

Most people with FND return to normal activities and their symptoms get better. There is no specific recovery timeline and flare-ups do occur. The toolset your care team gives you will help you manage these symptoms at home.

Appointments/Referrals 

• If you believe you have FND and you would like an assessment, ask your primary care provider for a referral to Neurology.
• If your child has already been diagnosed with FND, has been referred to physical and occupational therapy, and you wish to schedule an appointment with a Lurie Children’s provider, follow either of these steps: 
  • On MyChart – Once you log in, go to “Schedule an Appointment” > Select “Physical or Occupational Therapy” > Select “Other”
  • Call 312.227.6240 to speak with a department representative, directly. Let them know that you are calling to schedule an “FND evaluation”
• Our FND psychologists work with the neurology team to evaluate our patients and create a short-term treatment plan related to functional neurologic symptoms. Your child’s Lurie Children’s neurologist can give you a referral to our FND psychologist. 

Resources

For more information on FND, visit the National Institute of Neurological Disorders and Stroke.