Understanding Functional Neurological Disorder (FND)

Functional Neurological Disorder (FND) is a common and often misunderstood neurological condition where the brain has trouble sending and receiving signals correctly.

You can think of your body like a computer: in many neurological diseases, the "hardware" (the physical structures like nerves or the brain) is damaged. In FND, however, the "hardware" is intact, but there is a problem with the "software" – the way information moves through the system and is processed by your brain.

FND arises from disruptions in brain networks – specifically those responsible for movement, cognition, vision, sensation, and emotional processing. This can lead to a state of hyperarousal, worsening symptoms and making the brain oversensitive to emotional and sensory signals (e.g. touch, sound, sight). These symptoms, which are very real and involuntary, may include:

• Non-epileptic seizures and blackouts

• Movement problems (weakness, tremors, etc)

• Problems with cognitive function

• Dizziness

• Speech difficulties, such as sudden onset of stuttering or trouble speaking

• Problems with vision or hearing

• Pain (including chronic migraine)

• Extreme slowness and fatigue

• Numbness or inability to sense touch

While FND varies between people, there are similarities in common, and people can experience a range of symptoms affecting multiple systems of the body. People also frequently experience chronic pain, fatigue and cognitive fog along with their FND symptoms.

The “invisibility” of FND is extremely difficult for those with the condition. Because the physical structures in the brains and spines of people with FND appear normal in scans and other imaging, and symptoms aren’t always easily observed or issues don’t show up in medical tests. This can lead some medical professionals to question the reality of a person’s experiences, especially when FND has been a highly stigmatised diagnosis. This can lead some people to question the validity of their symptoms and experience (many fear that it’s “all in their head”), and the burden of trying to get the medical profession to take them seriously can take a toll.

Despite the prevalence of FND, it continues to be a largely under-researched, stigmatised and misunderstood. However, in recent years, it’s been exciting to see a groundswell of interest in FND in NZ and internationally.