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Functional Neurological Disorders

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Functional Neurological Disorders (FND) subtypes: including-Functional Movement Disorders, Conversion Disorder, Psychogenic Seizures, Non-Epileptic Seizures:

In FND there is a problem with the functioning of the nervous system and how the body and brain sends and receives signals.  It is therefore a disruption in the signals in FND and not a structural disease process such as in MS, it can be compared to an issue with the running of a computer programme rather than the computer itself.

In FND as the central nervous system is involved, any symptom at all that can be linked to the brain can present, and common manifestations of FND can be motor weakness or movement, convulsive episodes or even blindness.  It can range from permanent and severe disability which confines people to a wheelchair, to minor ongoing symptoms that can still be massive irritants in a person’s life, interrupting functioning and sleep, or having effects such as a mild tremor which can be felt anywhere in the body.  It can also present episodically in the form of non-epileptic fits with symptoms clearing up between episodes, and whilst each person’s presentation has commonalities, there are however also very individualised elements.

FND is a fairly common cause of disability and distress and can co-exist with chronic pain and fatigue. It is a diagnosis of specific clinical presentation that can vary from person to person, but generally a weakness, tremor, spasm, affected walking gait, functional speech pattern, functional sensory disturbance such as numbness or tingling, visual symptoms, and seizure related episodes are present.

Symptoms vary greatly over time and have very unique presentations for each individual ranging from constant, to episodic, to complete remittance.

Psychological crossover in FND is where emotional stress is not processed within the brain in the most helpful way for an individual and therefore goes on to disrupt their central nervous system instead.

In some sufferers this crossover proves to be relevant and can contribute to the predisposition and maintenance of FND for a person.  In other people this psychological crossover with their physical symptoms is just not found even after much therapeutic exploration.

In FND sufferers where psychological crossover does exist, this can be a very helpful discovery on their journey to physical improvement because new and healthy stress identification and management techniques can be learnt and adopted by an FND sufferer.

The idea is that their troublesome physical disruption in the central nervous system will stop being so agitated by unprocessed stress, and therefore fewer physical symptoms should present for an individual.  A tougher investigation in the therapy room is undertaken to expose this.

People with FND generally present in the therapy room as very good life copers , but unfortunately this can trigger the brain to store their emotional stress and convert this stress into physical symptoms.   

If there appears to be no emotional crossover after exploration, lots of other rehabilitation strategies can be engaged with that are appropriate to the FND presentation.

The experience of FND is such a frightening one for sufferers, so management of all of the emotional impacts that the condition has on a person, can be very helpful.  Having FND can be a very lonely and isolating place, especially if the symptoms cannot be seen, and it recognised by specialists to be a very tough condition to cope with.

There are many ways to help with FND in the therapy room, but as this is a very complex functional condition treatment takes time, therefore improvement, and recovery where feasible, takes pateince and hard work.  In instances where recovery is not realistic all rehabilative efforts are aimed at slowing physical decline and the worsening, or spreading, of symptoms.

Non epileptic seizures have really good therapeutic outcomes if treated correctly in the therapy room, and Pam has had many clients that are now completely fit free following therapy.