What is Functional Neurological Disorder?
Today, April 13th, 2024, marks Functional Neurological Disorder (FND) Awareness Day. This day is dedicated to raising awareness about Functional Neurological Disorder, a condition that affects the nervous system and how the brain and body communicate. FND Awareness Day aims to increase knowledge about the disorder among the public, healthcare professionals, and policymakers. The focus is on educating people about the symptoms, treatments, and challenges faced by those with FND and highlighting the importance of research and improved clinical practices. This day also provides an opportunity for individuals affected by FND, along with their families and caregivers, to share their stories and advocate for better support and resources. The goal is to reduce stigma, improve care, and foster a supportive community for everyone impacted by FND.
What is Functional Neurological Disorder?
Functional Neurological Disorder (FND) is a health condition with a problem with the nervous system, which is the part of the body that sends messages back and forth between the brain and the body. This issue isn't caused by structural damage to the brain or nerves but rather by the brain not sending and receiving messages properly.
In simple terms, FND affects how the body and brain communicate. People with FND can experience a wide range of symptoms, such as problems with walking, feelings of weakness, shaking, or sudden movements they can't control. They might also have trouble speaking, feel changes in their senses like vision or touch, and experience bladder issues or changes in thinking and memory. FND symptoms are genuine and can significantly impact a person's life.
People most likely to get FND are often women, although men can also develop it. The condition is most seen in people between 35 and 50 years old. But anyone at any age can be affected by FND, including children and teenagers.
Diagnosing FND involves a few steps, and it's important to know that it's not just about ruling out other diseases. A neurologist will do a clinical examination, and they will specifically look for signs that are common with FND. There are special tests doctors do to see if the symptoms match those typical of FND:
Hoover's Sign: This is when a doctor checks for leg weakness.
Adductor Sign: This test involves looking for involuntary muscle movements.
Whack-a-mole: This is when one symptom pops up in place of another when the doctor tries to control the first one.
Drift without Pronation: The doctor asks the patient to stretch out an arm and watches how it moves.
Tubular Vision: The doctor tests for specific changes in how the patient sees.
Impact of Attention: The doctor checks how symptoms change when the patient is distracted.
Diagnosing FND involves specific tests and observations, not just checking that it isn't something else. This approach ensures accurate diagnosis, helping patients get the proper treatment.
How can a physiotherapist help?
Physiotherapists play an essential role in managing FND by focusing on the neuroplasticity of the nervous system. This approach aims to retrain the brain's pathways, essentially helping to restore standard nerve signal transmission and muscle actions.
They start by educating patients on how FND affects their bodies, which helps demystify symptoms and reduces movement-related fear.
Techniques to promote normal movement patterns are used to override the dysfunctional signals causing FND symptoms.
Regular practice and training are needed as they help reinforce these normal pathways, improving motor control.
Physiotherapists also address secondary changes by adapting daily routines and increasing physical activity, enhancing general health, and lessening the impact of FND symptoms.
They create tailored symptom management plans for each patient's needs, including managing pain fatigue, and improving mobility.
Physiotherapists can also provide support and guidance on using assistive devices that help improve the quality of daily life.
How can an occupational therapist help?
Occupational therapists are part of the multidisciplinary team by helping individuals with FND adapt to their daily activities and work environments, improving their quality of life.
An occupational therapist may start with a functional assessment, which involves looking at how FND affects a person's daily activities at home and work and finding ways to help them be more independent.
They introduce assistive technology, which includes tools and techniques that make everyday tasks easier, especially when physical or cognitive symptoms of FND make these tasks challenging.
They also help with cognitive and behavioural strategies to manage memory problems or difficulty solving problems.
Occupational therapists recommend changes to the environment at home or work to make it safer and more functional, reducing risks and improving how people with FND can function in those spaces.
They support patients returning to work by creating step-by-step programs that consider the person's mental and physical abilities and limitations.
These therapies, often delivered in a multidisciplinary context, help ensure a holistic approach to treatment, addressing both the physical and psychological aspects of FND. The team must work closely to create a comprehensive care plan for the individual's needs.
The above information has been sourced from the Functional Neurological Disorder Australia website and the article "Functional neurological disorders: mechanisms and treatment" .
Please note that the information provided is for general informational purposes only and is not intended as medical advice. If you have any concerns or questions about your health or are considering any treatment, please consult with your general practitioner.
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