Functional Neurological Disorders (FND) Masterclass
Earlier this month our specialist Neuro Physiotherapist, Jen attended the Functional Neurological Disorders (FND) Masterclass, hosted by King’s College in London. It was a chance to learn from the leaders of the latest research into FND and its management.
So, what do we now know about this prevalent, commonly misunderstood condition?
Frequently marginalised in the late 20th century, the last decade has seen advances in this area of research and FND is now recognised as a brain network disorder, which affects the way signals/messages are received and sent through the body. This can result in a range of neurological symptoms, including; limb weakness, paralysis, seizures, spasms, sensory issues, brain fog, issues with speech, walking difficulties, to name a few. The effects can be severe and disabling.
The symptoms themselves resemble those that are seen in structural or degenerative neurological disease but have a fundamentally different mechanism. Essentially FND is a brain/nervous system ‘functioning’ issue, rather than a structural issue. The basic wiring of the nervous system is intact, however, communication is altered resulting in problems with movement control and attention. Importantly, symptoms are not consciously controlled.
So why might this happen?
In truth, there isn’t really a clear understanding of the sole cause, however potential risk factors have been identified, usually a culmination of biological, psychological, and social factors. Physical injuries and pain can be a trigger, equally anxiety, depression and past trauma can make brains vulnerable towards developing FND. It’s important to note, you don’t have to be anxious or depressed to develop FND, the reality is that anyone can be affected.
A common scenario usually sees a culmination of; working hard/becoming fatigued, followed by a “typical” physical event (illness, injury), alongside “normal” chronic life stressors. On this foundation, the physical triggering event for FND is usually something that would be expected to get better, for example, a flu that would be expected to go after a few days’ rest, but instead, symptoms continue and functional symptoms emerge.
Diagnosis should be made on positive neurological signs and tests, which are specific to FND. For instance, your neurological consultant may perform a test called ’Hoover’s sign’ to assess lower limb weakness. Specific testing can avoid misdiagnosis, a consideration when FND can co-occur alongside other neurological diseases.
Treatment
Symptom management and/or recovery is possible with access to appropriate treatment. A holistic approach to treatment is recommended, which may include access to Psychiatry/psychology (including CBT), Neurology, Neuro-physiotherapy, Speech and Language Therapy, Occupational Therapy, Social care etc.
Evidence is growing that Neuro-physiotherapy can be the most effective treatment for those who have movement or motor symptoms such as weakness and walking difficulties. Increased attention/hypervigilance of symptoms can reinforce FND symptoms, hence much of Neuro-physiotherapy management includes distraction/diverting attention away from the body. This can help re-set the brain and nervous system, allowing for automatic movements to return. The focus is to regain normal movement and function.
If you feel you, or someone you know would benefit from Neuro-physiotherapy, please contact the clinic on 0113 250 8833 to speak to one of the team or to book an appointment.
For more information on FND.
- FND Action FND Action – Home
- FND Hope HOME FND Hope – FND Hope International
- Neuro symptoms.org Functional Neurological Disorder (FND) – A Patient’s Guide to FND