Functional Neurological Disorders

Functional Neurological Disorders | Dr. Ali Ghahary

A functional neurological disorder (FND) is an umbrella term that is used to describe a variety of neurological symptoms. Structurally, the brain of a patient with a functional neurological disorder may appear to be normal. However, it functions incorrectly, making the brain unable to send and receive signals properly.

Common symptoms associated with functional neurological disorders include bladder and bowel changes, gait and balance problems, headaches and migraines, paralysis and weakness, visual changes, speech problems, sleep disturbances, involuntary movements, seizures, cognitive changes, sensory changes, and chronic pain. Below is a more in-depth look at some of these symptoms.

Bladder and Bowel Changes
Overactive bladder is something that individuals with a functional neurological disorder may experience. This is because several systems work together to control the bladder, including the muscle. Nerves carry signals from the brain to tell the bladder when it’s full and when we need to urinate. However, if the brain is not receiving signals properly, the signals from the brain to the bladder can be impacted. This can result in a more urgent need to urinate, feeling as though you have to urinate even if you’ve just used the restroom, waking up to urinate throughout the evening, bedwetting, and leaking urine. The good news is urinary incontinence can be treated, and while it may be embarrassing it isn’t something you should be ashamed to bring up to a trusted healthcare professional, such as a family physician like Dr. Ali Ghahary.

Gait and Balance Problems
Gait is a term used to describe the manner in which someone walks. As sensory signals from the muscles to the brain can be disrupted, one may develop foot dragging or stiffness. Someone with gait/balance problems are more susceptible to injury as a result of stumbling or falling. To learn different methods of dealing with these issues, patients will benefit from seeing both physical and occupational therapists. Staying physically active can also help to maintain muscle strength.

Headaches and Migraines
Individuals with a functional neurological disorder may experience chronic daily migraines or headaches. In order to fit the criteria of chronic daily migraines/headaches, the patient must experience a migraine or a headache for 15 days (or more) each month. Chronic headaches and migraines cannot be cured, but can be treated with things like medication, physical therapy, psychotherapy, biofeedback, relaxation techniques, acupuncture, and even dietary changes.

Paralysis and Weakness
Due to the nervous system not working properly, FND-diagnosed individuals may experience functional weakness – also known as dissociative motor disorder. Symptoms are similar to those of multiple sclerosis. However, unlike MS, functional weakness poses no risk of permanent damage. Examples include heaviness down one side of the body and abnormal feelings of the limbs. You may also drop things more frequently.

Visual Changes
Double vision, also known as diplopia is a common symptom in individuals with a functional neurological disorder, and it may be accompanied by things like difficulty reading, nausea, headaches, dry eyes and bloodshot eyes. You may also see what appears to be halos around lights. In addition to diplopia, patients may also experience a condition known a photophobia, which is sensitivity or the inability to tolerate light, causing the need to quint or close the eyes. Similar to diplopia, photophobia can also cause headache or nausea, and may even trigger seizures.

For more information about functional neurological disorders, visit: