An Overview of FND
In today’s digital world, it’s common to turn to search engines like Google for answers on unfamiliar topics. However, when searching for information on Functional Neurological Disorder (FND), the results can often feel overwhelming and confusing. Unfortunately, FND is a condition that is not well understood, researched, or widely known. This lack of awareness makes living with FND, and supporting those affected, even more challenging. Unlike many other topics, accurate information about FND isn't easily found with a simple Google search.
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A helpful way to approach FND is by seeing it as a puzzle. Each piece is distinct yet connected, contributing to a fuller understanding of the condition. For example, one part of the puzzle involves exploring how the brain communicates with the body. Another part is understanding what FND truly is, while a crucial piece lies in analyzing the latest research. By putting these pieces together, we start to form a clearer picture of FND.
The issue at hand is that we are still lacking many crucial pieces of the puzzle. While we do have some pieces that provide a starting point, we are far from having a complete picture. However, these initial pieces give us a direction for asking important questions. It is these unanswered questions that drive research forward. Research is essential for gaining a deeper understanding of the condition. This understanding is crucial for developing more effective treatments. Improved treatments are necessary to give the FND community a better chance at recovery. Let's continue to push forward in our quest for answers and solutions.
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FND Statistics
The average time to receive an diagnosis of FND is between 2-10 years (averages vary by research studies).
An estimated 4 -12 people per 100,000 will develop FND. It can occur in anyone, however it is more common in women and is uncommon in children under age 10.
What Is FND?
So, what exactly is FND? In simple terms, it’s a disruption in the communication system between the brain and the body. There’s no quick fix for FND—it requires hard work and perseverance. However, there is hope. Many people with FND have learned to manage their symptoms effectively and lead fulfilling lives, refusing to let the condition define them. Yet, despite their best efforts, others continue to struggle with persistent symptoms. The truth is, what works for one person may not work for another, making FND a particularly frustrating and challenging condition. In treating FND, the goal is to "repair" the communication breakdown between the brain and the body.
Do you remember the game of telephone? There is a line of people, and a person at the beginning of the line whispers a sentence to the next person. The next person whispers the same sentence to the next person in line, and so forth until it gets to the end (see video). Typically, by the time it gets to the end of the line, it is a completely different sentence.
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Let's relate this to FND and the brain: a similar effect happens when an area(s) in the brain malfunctions- the message that it is sending and/or receiving is being miscommunicated.
Steph Blanco shares her perspective of FND from her experiences of someone who both lives with FND and now also researches FND.
Prevalence
The exact prevalence of FND is unknown, and research is mixed. Some research suggests FND is the second most common reason for a neurological outpatient visit after headache/migraine, accounting for one sixth of diagnoses, meaning FND could be as common as multiple sclerosis or Parkinson’s disease. Other research suggests it is far less common.
FND does not discriminate - it can affect anyone, at any time. Although, again, the research is inconsistent, it appears to be uncommon in children under 10, and to affect females more than males for most symptoms (although research results depended on age group).
Diagnosis
FND should NEVER be a diagnosis of exclusion, but should rather be based on positive diagnostic signs. Examples of positive signs include the Hoover sign for weakness and balance issues which improve with distraction. The DSM-5 diagnostic criteria include:
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symptoms of altered voluntary motor or sensory function
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clinical findings incompatible with neurological or medical conditions
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symptoms that cannot be explained by another medical or psychiatric disorder, and
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symptoms that cause significant distress or impairment in social, occupational, or other important areas of functioning.