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Concept
Functional neurologic disorder
Summary
Functional neurologic disorder or functional neurological disorder (FND) is a condition in which patients experience neurological symptoms such as weakness, movement disorders, sensory symptoms and blackouts. As a functional disorder there is by definition no disease process affecting the structure of the body, yet the person experiences symptoms relating to their body function. Symptoms of functional neurological disorders are clinically recognisable, but are not categorically associated with a definable organic disease.
The intended contrast is with an organic brain syndrome, where a pathology (disease process) can be identified which affects the body's physiology. Subsets of functional neurological disorders include functional neurological symptom disorder (FNsD), conversion disorder, functional movement disorder and functional seizures. The diagnosis is made based on positive signs and symptoms in the history and examination during consultation of a neurologist (see below). "FND is the second most common diagnosis in neurology clinics after headaches," and has become more prevalent among adolescents and older adults in the wake of the COVID pandemic and lockdowns.
Physiotherapy is particularly helpful for patients with motor symptoms (weakness, gait disorders, movement disorders) and tailored cognitive behavioural therapy has the best evidence in patients with dissociative (non-epileptic) attacks.
There are a great number of symptoms experienced by those with a functional neurological disorder. While these symptoms are very real, their origin is complex, since it can be associated with severe psychological trauma (conversion disorder), and idiopathic neurological dysfunction.
Official source
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