Current diagnostic labeling is causing confusion. One doctor may use the term Functional Neurological Disorder or Functional Movement Disorder, but another may use Conversion Disorder. This leaves many confused on their diagnosis and struggling to find where they fit. Individually these terms have different meanings, however, they are all labels for the same disorder.
What is Functional Neurological Disorder:
Functional Neurological Disorder is due to a problem with the functioning of the nervous system. Functional symptoms are thought to derive from the brain’s inability to send and receive signals properly, as the result of physical and/or psychological precipitating factors.
Functional Neurological Disorder provides an umbrella term for a variety of symptoms of apparent neurological origin but which current models struggle to explain psychologically or organically. Presentation may be similar to a wide range of other neurological conditions. FND/CD can be as debilitating as Parkinson’s disease and MS and have many similar symptoms. The most common misconception is that patients are in control of some or all of their symptoms. The patient does not consciously produce functional symptoms. A patient with conscious control of their symptoms has a different diagnosis such as Feigning, Malingering, or Munchausen Syndrome.
Very few effective treatment plans exist. Physical Therapy is the most effective form of treatment with a goal of re-introducing proper movement and motor control. The most common treatment plan is Cognitive Behavior Therapy (CBT), which yields a 13% 1 success rate. CBT is most effective for patients who have a psychological connection to their symptoms. Researchers, money, and volunteers are greatly needed.
Functional Neurological Disorder can present with any motor or sensory symptoms in the body including:
- Chronic Pain
- Non-Epileptic Seizures
- Speech Problems
- Involuntary Movements
- Bladder/Bowel Changes
- Cognitive Changes
- Visual Changes
- Sensory Symptoms
- Sleep Disturbances
- Gait/Balance Changes
Given the occurrence of these medically unexplained symptoms in patients with organic brain injury, spinal injury, post-anesthesia and post-viral illnesses, the modern term moves away from psychodynamic theory and provides a useful label for what is a complex and little understood disorder.
Name Change: The additional parenthetical “functional neurological symptom disorder” has been introduced as it is more frequently used by neurologists who see the majority of these patients. Specialists who are current with research and understand the complexities of these symptoms are also moving away from the term Conversion Disorder. Conversion Disorder is more specific for those patients who can clearly define a psychological connection, which they are “converting” to their physical symptom. The majority of our Functional members do not relate to the “conversion theory”.
GUIDED SELF-HELP FOR FUNCTIONAL (PSYCHOGENIC) SYMPTOMS, A randomized controlled efficacy trialM. SHARPE, MD, J. WALKER, MBCHB, C. WILLIAMS, MD, J. STONE, PHD, J. CAVANAGH, MD, G. MURRAY, PHD, I. BUTCHER, PHD, R. DUNCAN, MD, PHD, S. SMITH, PHD AND A. CARSON, MD, HTTP://WWW.NEUROLOGY.ORG/CONTENT/EARLY/2011/07/27/WNL.0B013E318228C0C7.ABSTRACT#