Functional neurological disorder (FND) is a psychiatric disorder in which individuals experience physical symptoms that cannot be explained by a medical cause. These symptoms may be real and distressing, but medical tests and examinations do not reveal any physical cause. The causes of functional neurological disorder can be complex and may involve a combination of psychological, biological, and environmental factors. The treatment for this disorder focuses on reducing the severity of symptoms and restoring functionality. It is also important for the patient to understand the psychological factors underlying their physical symptoms and learn to cope with these factors. Treatment may require a multidisciplinary approach, involving collaboration between different healthcare professionals such as psychiatrists, psychologists, and physical therapists.
What Are the Causes of Functional Neurological Disorder?
The causes of functional neurological disorder are complex and not fully understood. However, there are some possible contributing factors and mechanisms that may contribute to the development of such disorders:
Psychological Factors: Many of the symptoms of FND can be associated with an individual’s psychological state.
Somatization: Somatization is a process in which individuals tend to express emotional or psychological stress through physical symptoms, which can later be identified as part of FND.
Neurobiological Factors: Some studies suggest that FND symptoms may be associated with neurobiological changes.
Personality Traits: FND may be more common in individuals with obsessive-compulsive traits or notable personality disorders.
Trauma History: Physical or psychological traumas may play a role in the development of FND symptoms.
Environmental Factors: Environmental factors may trigger the onset or affect the severity of FND.
What Are the Symptoms of Functional Neurological Disorder?
The symptoms of functional neurological disorder can be real and distressing, but medical tests and examinations do not reveal any physical cause:
- pain, neurological symptoms
- difficulty swallowing
- speech problems
- movement disorders
- seizure-like neurological events
- respiratory problems
- stomach problems
- eye problems
- urinary problems
How Is Functional Neurological Disorder Diagnosed?
The diagnosis of functional neurological disorder involves a diagnostic process in which other medical causes are ruled out and the psychological origin of symptoms is determined:
Medical Evaluation: Initially, the individual’s symptoms and medical history are carefully examined.
Laboratory and Imaging Tests: Before diagnosing FND, laboratory tests may be conducted to rule out medical causes.
Neurological Examination: If there are neurological symptoms, a neurological examination is performed.
Psychological Evaluation: A psychological evaluation by a psychologist or psychiatrist may be conducted to assess the psychological origin of symptoms.
Diagnostic Criteria: The diagnosis of FND is based on criteria that determine that the symptoms cannot be explained by medical causes and are associated with psychological factors.
Monitoring of Symptoms: Monitoring of symptoms is important in the diagnostic process.
How Is Functional Neurological Disorder Treated?
The treatment for functional neurological disorder focuses on symptom management, restoration of functionality, and understanding the psychological origins of symptoms:
Psychotherapy: Psychotherapy is the cornerstone of FND treatment. Psychotherapy types such as cognitive-behavioral therapy (CBT) or psychodynamic therapy may be used.
Stress Management: Stress can trigger or worsen FND symptoms. Therefore, patients are taught stress management techniques.
Supportive Therapies: Supportive therapies may also be used in the treatment of FND.
Medication: Medication may sometimes be used to manage FND symptoms.
Educational Support: It is important to provide education about FND to both patients and their families.
Monitoring and Follow-up: FND treatment involves monitoring the progression of symptoms and response to treatment.
How Should Functional Neurological Disorder Be Managed?
The management of functional neurological disorder requires a multidisciplinary approach aimed at controlling symptoms, improving functionality, and enhancing quality of life:
Psychotherapy: Psychotherapy plays a fundamental role in managing FND symptoms. Psychotherapy types such as cognitive-behavioral therapy, psychodynamic therapy, or neurotherapy may be used.
Stress Management: Stress can trigger or worsen FND symptoms. Therefore, patients are taught stress management techniques.
Medication: Medication can help alleviate or manage the severity of symptoms.
Physical and Speech Therapy: Supportive therapies such as physical therapy, speech therapy, and occupational therapy can help improve daily life skills and increase independence.
Educational Support: It is important to provide education about FND to both patients and their families.
Monitoring and Follow-up: FND management involves monitoring the progression of symptoms and response to treatment.
Support Groups: Joining support groups to cope with FND can help patients share their experiences with others and receive emotional support.
