Functional neurological disorder, or FND, is defined as a nervous system problem. In FND, no structural damage or disease is observed, however, the brain and body develop a pattern of miscommunication through the nervous system. The sympathetic nervous symptom (“gas pedal” of the body) becomes highly sensitized and triggers big, involuntary reactions in the body when overwhelmed by information and the parasympathetic nervous system (“brakes”) is unable to activate. Common reactions include paralysis, weakness, tremors, jerky or unexpected movements, difficulties with speech, or swallowing changes. These functional symptoms occur, in part, because the brain has a hard time making sense of stressors. Stressors can be physical like a poor night’s sleep or injury, or social-emotional, like a difficult family event or school work/problem. Traumatic events are also associated with functional symptoms. FND is commonly “episodic”, meaning that symptoms come on suddenly, get better, and emerge again at a later time. Things that can keep FND going include trouble with shifting attention, increased focus on physical sensations in the body, and difficulty with recognition and response to stressors. FND is most commonly diagnosed by a neurologist and can occur with or without a structural diagnosis (i.e., epilepsy.) FND can dramatically impact a person’s life. A multidisciplinary treatment approach is recommended, including medical intervention, physical therapy, and cognitive behavioral therapy.
