What is Functional Neurological Disorder (FND) and why is it so difficult to diagnose?
Functional Neurological Disorder or FND describes a problem with how the brain receives and sends information to the rest of the body.
It occurs as a malfunction in the nervous system which allows us voluntary access to movement and cognitive control and to the normal perception of our body. The problems that cause FND are going on in a level of the brain that cannot be controlled.
FND can affect anyone of any age and the neurological symptoms are, for many, a cause of disability and impairment on their quality of life and participation in society. The symptoms, disabilities and co-morbidities of people with FND also vary widely from person to person and include:
- difficulty moving, for example walking or controlling your arms and legs;
- problems balancing;
- tingling sensations or twitches in the body;
- headaches, migraines or dizziness;
- changes in eyesight, for example blurred vision;
- pain, which is sometimes hard to locate, combined with tiredness;
- seizure-like episodes; and
- cognitive ‘fog’
FND can happen for a wide range of reasons. There’s often more than one reason, and the reasons can vary hugely from person to person.
Some of the reasons why the brain stops working properly in FND include:
- the brain trying to get rid of a painful sensation
- a migraine or other neurological symptom
- the brain shutting down a part or all of the body in response to a situation it thinks is threatening
Many people with FND have other chronic health problems or have experienced the triggering of FND through acute health events such as injuries or accidents. A proportion of people also have mental health conditions, including post-traumatic stress disorder. These complexities can make finding expertise in diagnosis and rehabilitation for people with FND challenging.
Access to specialist care, or lack of appropriate care, continues to be a serious issue in most parts of the UK. Healthcare costs associated with FND are high, as are the associated costs of social care, indirect costs from lost earnings and provision of unpaid care by a family member. This leads to many people diagnosed with FND being left to struggle on their own, desperately trying to find any care and support which may help them.