Your FND Recovery Pathway

Functional Neurological Disorder (FND) is a condition that affects how the brain sends and receives signals⁴. This can cause many different symptoms, which can include trouble moving, shaking, seizures, or thinking difficulties⁴.

For many people, the journey to recover from FND isn’t a straight or easy path. In fact, for some, it can take many years just to get the right diagnosis¹. This delay in diagnosis often happens because FND is not yet widely understood within our healthcare system.

When you first start having FND symptoms, for example, seizures, weakness/paralysis, or trouble with balance, you may feel confused or scared³. You might not know what’s happening or who to talk to but it’s important to get medical help as soon as you can².

Start by seeing your family doctor or going to the emergency room if your symptoms are serious⁴. At this stage, doctors will check to make sure your symptoms aren’t being caused by other medical problems⁴. To do this, they might use different tests, such as blood tests, nerve tests, an EEG (which checks your brain’s electrical signals), or an MRI (which takes pictures of your brain and body to look for problems)^4,5.

After these first steps, you may be referred to a neurologist. A neurologist is a doctor who specializes in the brain and nervous system. Neurologists can help confirm whether you have FND and talk about what happens next.⁶

Your Healthcare Team during FND Recovery

Living with FND means you’ll likely need to work with a team of health care providers for an extended period^2,5. This team may include one or more of your neurologist, family doctor, physiotherapist, chiropractor, occupational therapist, speech language pathologist, and psychologist or other mental health professional^2,5

Some ways your multi-disciplinary team can support you in your FND recovery include the following:

1. Physiotherapist/Chiropractor⁷
   • Retrain balance, vision, posture, and movement patterns (e.g. walking)
   • Improve coordination and strength
   • Increase exercise tolerance
   • Reduce physical symptoms through active rehabilitation and manual (hands-on) therapy
2. Occupational Therapist⁸
   • Fatigue and pain management
   • Strategies to manage stress and anxiety
   • Adapt tasks or environments for independence
   • Modifications to daily routine
   • Strategies to support you at work or in school
   • Cognitive (thinking) strategies
   • Target symptom management (i.e., strategies to take control of functional seizures)
3. Speech Language Pathologist⁹
   • Assist with voice disorders or stuttering
   • Support with swallowing or other upper airway problems (e.g. coughing or breathing)
   • Strategies for communication (e.g. speech initiation)
   • Cognitive communication strategies (e.g. hearing, speaking, participating in social settings)
4. Mental health professional (e.g. psychologist, psychotherapist, social worker)^10,11

1. • Provide psychotherapy (e.g. cognitive behaviour therapy, psychodynamic therapy, dialectical behaviour therapy)
   • Hypnosis therapy
   • Address anxiety, depression, or trauma
   • Teach coping strategies

Over the course of your recovery, your healthcare team will monitor your progress, and your treatment plan will be revised as necessary^4,5. Finding support through community groups either virtually or in person may also benefit your recovery process⁴.

Final Thoughts

Navigating the healthcare system during FND recovery be challenging and feel overwhelming at times. No two recovery journeys are the same and they will require the knowledge and expertise of different healthcare providers along the way. Sometimes you may try something and not get the results that you want right away. It is important to remember that recovery is a process that can involve trial and error. Collaboration and open communication with your health care team are key to successful outcomes.

References

1. McLoughlin, C., Hoeritzauer, I., Cabreira, V., Aybek, S., Adams, C., Alty, J., Ball, H. A., Baker, J., Bullock, K., Burness, C., Dworetzky, B. A., Finkelstein, S., Garcin, B., Gelauff, J., Goldstein, L. H., Jordbru, A., Huys, A.-C. M., Laffan, A., Lidstone, S. C., … McWhirter, L. (2023). Functional neurological disorder is a feminist issue. Journal of Neurology, Neurosurgery and Psychiatry, 94(10), 855–862. https://doi.org/10.1136/jnnp-2022-330192
2. Bennett, K., Diamond, C., Hoeritzauer, I., Gardiner, P., McWhirter, L., Carson, A., & Stone, J. (2021). A practical review of functional neurological disorder (FND) for the general physician. Clinical Medicine (London, England), 21(1), 28–36. https://doi.org/10.7861/clinmed.2020-0987
3. MacDuffie, K. E., Grubbs, L., Best, T., LaRoche, S., Mildon, B., Myers, L., Stafford, E., & Rommelfanger, K. S. (2021). Stigma and functional neurological disorder: a research agenda targeting the clinical encounter. CNS Spectrums, 26(6), 587–592. https://doi.org/10.1017/S1092852920002084
4. FND Friends. (n.d.). What is FND? https://fndfriends.com/what-is-fnd/#:~:text=Diagnosis%20&%20causes&text=The%20first%20thing%20you%20would,NOT%20a%20Medically%20Unexplained%20Symptom.
5. National Institute of Neurological Disorders and Stroke. (n.d.). Functional Neurological Disorder. https://www.ninds.nih.gov/health-information/disorders/functional-neurologic-disorder
6. Gilmour, G. S., Nielsen, G., Teodoro, T., Yogarajah, M., Coebergh, J. A., Dilley, M. D., Martino, D., & Edwards, M. J. (2020). Management of functional neurological disorder. Journal of Neurology, 267(7), 2164–2172. https://doi.org/10.1007/s00415-020-09772-w
7. Propel Physiotherapy. (n.d.). Functional Neurological Disorder Treatment. https://propelphysiotherapy.com/neurological/functional-neurological-disorder-treatment/
8. Nicholson, C., Edwards, M. J., Carson, A. J., Gardiner, P., Golder, D., Hayward, K., Humblestone, S., Jinadu, H., Lumsden, C., MacLean, J., Main, L., Macgregor, L., Nielsen, G., Oakley, L., Price, J., Ranford, J., Ranu, J., Sum, E., & Stone, J. (2020). Occupational therapy consensus recommendations for functional neurological disorder. Journal of Neurology, Neurosurgery and Psychiatry, 91(10), 1037–1045. https://doi.org/10.1136/jnnp-2019-322281
9. Baker, J., Barnett, C., Cavalli, L., Dietrich, M., Dixon, L., Duffy, J. R., Elias, A., Fraser, D. E., Freeburn, J. L., Gregory, C., McKenzie, K., Miller, N., Patterson, J., Roth, C., Roy, N., Short, J., Utianski, R., van Mersbergen, M., Vertigan, A., … McWhirter, L. (2021). Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. Journal of Neurology, Neurosurgery and Psychiatry, 92(10), 1112–1125. https://doi.org/10.1136/jnnp-2021-326767
10. Gutkin, M., McLean, L., Brown, R., & Kanaan, R. A. (2021). Systematic review of psychotherapy for adults with functional neurological disorder. Journal of Neurology, Neurosurgery and Psychiatry, 92(1), 36–44. https://doi.org/10.1136/jnnp-2019-321926
11. FND Hope. (n.d.). Treatment Psychological. https://fndhope.org/fnd-guide/treatment/psychological/

Disclaimer: The content provided on this website is for informational and educational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Always seek the advice of a qualified professional with any questions you have regarding your health.