FUNCTIONAL NEUROLOGICAL DISORDER
Functional Neurological Disorder (FND) is an umbrella term for a variety of symptoms that appear neurological in nature but that doctors are unable to explain organically. Essentially, there is nothing wrong with the physical structures of the body (ie: nothing will show up on an MRI) but yet FND patients present with symptoms that should have something show up on a test. The brain has difficulty communicating with the nervous system and body, and vice versa, but there is nothing organically wrong with the patient’s brain. Much the same way a computer may not have a hardware problem, but could have a software problem, leading the computer to malfunction. Presentation can be similar to a wide range of other neurological disorders and can have similar symptoms to and be as debilitating as MS or Parkinson’s disease. FND can present with any motor or sensory symptoms in the body.
Since little is known about the cause and prognosis of FND, little is also known about how to treat it. Physical Therapy is the most effective form of treatment as it reintroduces proper movement and motor control. For me, physio-therapy allowed me to relearn how to walk because my brain essentially had forgotten how to do so. However, Cognitive Behavior Therapy is the most common form of treatment with a 13% success rate. This is commonly used in patients who have a known psychological connection to their symptoms (ie: symptoms came on after an emotional trauma.) Lack of understanding of the condition among researchers, doctors and the general public has negatively influenced the treatment and care of patients. There is much stigma surrounding the illness. Many believe the disorder is psychological in nature and that FND patients are feigning or imagining their symptoms. Therefore, research and funding is greatly needed.
FND PATIENTS ARE NOT MAKING UP THEIR SYMPTOMS (MALINGERING.) FND SYMPTOMS CAUSE FINANCIAL, PHSYICAL, MENTAL AND EMOTIONAL DISTRESS AND CANNOT BE TURNED OFF AT WILL. AS WITH MANY OTHER CONDITIONS SYMPTOMS MAY WAX AND WANE.
Symptoms may include: bladder and bowel changes (such as overactive bladder, incontinence or irritable bowel syndrome), chronic pain, cognitive changes, (such as brain fog, memory loss, disassociaive amnesia, and depersonalization) gait and balance problems, headaches and migraines, involuntary and abnormal movements, (such as restless leg syndrome, tremor, tics, myoclonus, and dystonia) paralysis and weakness, seizures, sensory changes (electrical sensations, tinnitus, hyper-sensitivity to food textures, etc) sleep disturbances (insomnia and hypersomnia), speech problems, (aphonia, dysphonia, stuttering, dysarthria) and visual disturbances, (dyslopia and photophobia). For definitions of some of the terms used here, please visit my Glossary page.
In my case I experienced gait disturbance and weakness in my legs that eventually lead to an inability to walk or move my legs at all. Almost like a paralysis from the waist down. I was also unable to void my bladder or bowels and often had to be catheterized. With the help from a physio-therapist over the 4 weeks I was admitted to hospital I re-learned to walk and eventually was discharged. Over the year since the diagnosis many of my symptoms have been controlled. I am currently able to walk (though I have difficulty with stairs) but sometimes I do have a bit of a gait disturbance (basically, I walk funny) and trouble with balance. Some days I must use a cane, which also helps when I am dizzy or woozy, as I have a little extra help with standing upright. I also experience bladder changes (as part of my interstitial cystitis: see below) chronic pain (also part of my fibromyalgia: see below), cognitive changes such as brain fog and I have a hard time remembering things (I use a lot of reminders on my phone and post-it notes), headaches and migraines, involuntary movements such as restless legs syndrome and some tremors, sleep disturbances, and visual disturbances (my vision is awful).