So, who can get FND?

What is FND Part 3

You may be surprised that anyone can be vulnerable to FND, and while many factors are known to increase risk, these are neither definitive nor exclusive and there is still no consensus on precisely what causes the disorder to manifest. However, when considering a patient with FND, it’s useful to evaluate them against the 3Ps of the cognitive behavioural model:
Predisposing (factors): illness; personality traits; life events; stressors

Precipitating (triggers): injury; traumatic event (either physical or psychological)

Perpetuating (symptoms): what keeps the symptoms alive? Fatigue, chronic pain, illness beliefs, co-morbidities (anxiety/depression) social stressors and also being within the compensation process.

More commonly, people diagnosed with FND will relate to a number of the above.

What are the signs and symptoms we need to be looking for? 

Since classification is clearer and patients can now gain an unequivocal FND diagnosis, how does this look in practical terms?

As we have seen across Reach, FND clients can experience a wide range and combination of symptoms that are physical, sensory and/or cognitive. This is where the rehab approach needs to be focussed and the assessment needs to be very specific to gain an accurate baseline.

Typical symptoms:

There are a range of typical signs and symptoms within the disorder, the more common ones come under three clinical headings.

Motor dysfunction:

• Limb weakness and paralysis
• Functional movement disorders including tremors, spasms and jerky movements – all leading to problems with walking
• Functional speech symptoms including slurred or stuttering speech in addition to whispering speech (dysphonia).

Sensory dysfunction:

• Functional sensory disturbance which includes altered touch sensation including numbness, tingling or pain in the face, torso or limbs, (this often occurs unilaterally, which has been the case with several Reach FND patients)
• Functional visual disturbances, including loss of vision or double vision.

Cognitive symptoms

• Dissociative (non-epileptic) seizures presenting as blackouts and faints
• Fatigue – cognitive and physical
• Sleep problems
• Anxiety
• Memory problems
• Low mood
• Problems with planning/organising.

It is important to remember that these symptoms are quite real and often very disabling, and can co-exist alongside a diagnosable neurological condition (in around 10 – 20 per cent of cases).

More on Functional Neurological Disorder (FND)

Understanding FND is crucial for providing appropriate care and support to those affected by this often misunderstood condition. Learn more about Functional Neurological Disorder (FND)

Stay Tuned for Part 4, when we look at the Key points and Best Practices for the rehabilitation pathway.