Functional Neurological Disorder (FND)

Types and Variations of Functional Neurological Disorder

The most common types include:

• Functional or dissociative seizures – Also called psychogenic nonepileptic seizures (PNES), these episodes resemble epileptic seizures but are not caused by abnormal electrical activity in the brain.
• Functional movement disorder – Involves changes in movement such as tremors, jerks, spasms, gait problems, or weakness without a neurological disease as the cause.

Signs and Symptoms 

FND can present differently for each person. Symptoms may appear suddenly, change over time, or last for years. Parents and caregivers should be aware of:

• Pain, including chronic migraine
• Seizure-like episodes
• Numbness or loss of sensation
• Extreme slowness or fatigue
• Dizziness
• Speech changes, such as difficulty speaking or sudden stuttering
• Movement problems, including tremors or jerking movements
• Trouble walking, talking, seeing, hearing, swallowing, or balancing
• Cognitive challenges such as poor concentration or memory problems
• Weakness or paralysis
• Symptoms that worsen when attention is focused on them and improve when attention shifts elsewhere
• Trouble with memory and concentration
• Weakness or paralysis

Evaluation and Diagnosis 

Diagnosis begins with a thorough medical and neurological evaluation to rule out other conditions. This may include:

• Assessment of symptom patterns and triggers
• Brain imaging (MRI or CT scans)
• Neurophysiological testing (EEG, EMG)
• Psychological evaluation, when appropriate

A correct diagnosis is essential so patients can begin appropriate treatment and avoid unnecessary or ineffective interventions.