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SYMPTOMS / COMORBIDITIES

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Functional Neurological Disorder (FND) Overview

Functional Neurological Disorder (FND) causes real and often disabling symptoms related to how the brain and body send signals, rather than structural damage. With the right support and tools, many people see significant improvement.

Symptoms & Recommended Treatments

Motor Symptoms

Functional Weakness/Paralysis: Limb won't move but no damage.
- Treatment: Neurological physiotherapy, functional retraining, CBT.
Gait Disturbance: Variable walking problems.
- Treatment: Gait training, cueing, balance work.
Functional Seizures (PNES): Seizure-like episodes without abnormal brain waves.
- Treatment: CBT, trauma therapy, seizure response planning.
Tremors or Jerks: Sudden involuntary movement.
- Treatment: Distraction, movement retraining, biofeedback.
Functional Dystonia: Abnormal posture or tension.
- Treatment: Sensory tricks, neurological physiotherapy.

Sensory Symptoms

Numbness/Tingling (Paresthesia): Anywhere on the body.
- Treatment: Sensory retraining, grounding, somatic tracking.
Temperature Dysregulation: Feel hot or cold incorrectly, baseline temp ~35.5°C.
- Treatment: Pacing, layer clothing, temperature monitors.
Pain (No Structural Cause): Stabbing, burning, aching.
- Treatment: Pain education, CBT/ACT, graded exposure.

Speech & Swallowing

Voice Changes: Whisper, stuttering, aphonia.
- Treatment: Speech therapy, breathing control.
Swallowing Difficulty, Choking: Functional dysphagia.
- Treatment: Food modification, swallow therapy, CBT.
Globus Sensation: Lump-in-throat feeling.
- Treatment: Relaxation, reassurance, SLT.

Facial/Cranial Symptoms

Functional Facial Droop: Stroke-like appearance.
- Treatment: Facial retraining, reassurance.
Visual Disturbances: Blurred, tunnel vision, functional blindness.
- Treatment: Visual rehab, neuro-optometry.
Headache/Migraine: Often comorbid.
- Treatment: Migraine treatment, lifestyle management.

Cognitive/Perceptual

Dissociation: Disconnected from body or surroundings.
- Treatment: Grounding, trauma therapy, mindfulness.
Brain Fog: Trouble thinking or focusing.
- Treatment: Cognitive pacing, rest cycles.

Autonomic Symptoms

Orthostatic Intolerance / POTS: Dizziness standing up.
- Treatment: Salt, fluids, compression gear, pacing.
Heart Rate Fluctuations: Palpitations, irregular rhythm.
- Treatment: Breathing techniques, biofeedback.
Sweating Issues: Too much/little sweating.
- Treatment: Layering, cooling/fanning, skincare.

Gastrointestinal Symptoms

IBS: Cramping, bloating, diarrhea, constipation.
- Treatment: Low FODMAP diet, gut-directed CBT.
Functional Nausea/Vomiting: Persistent nausea without cause.
- Treatment: Anti-nausea meds, relaxation, slow eating.
Constipation/Diarrhea: Alternating bowel issues.
- Treatment: Pelvic PT, fiber, paced eating.

Common Comorbidities & Their Management

CRPS (Complex Regional Pain Syndrome): Local pain with skin/temp changes.
- Treatment: Mirror therapy, graded exposure.
CSS (Central Sensitization Syndrome): Heightened sensory sensitivity.
- Treatment: Desensitization, CBT/ACT, low-dose meds.
Fibromyalgia: Widespread pain and fatigue.
- Treatment: Gentle movement, CBT/ACT, sleep help.
POTS: Fast heartbeat when upright.
- Treatment: Salt, fluid intake, tilt training.
ME/CFS: Post-exertional crashes, exhaustion.
- Treatment: Energy pacing, rest cycles.
Dissociative Disorders: Disconnect from thoughts/body.
- Treatment: Trauma-informed therapy, EMDR.
Mental Health (PTSD, Anxiety, Depression): Highly comorbid.
- Treatment: Psychotherapy, meds if needed, mindfulness.
Functional Bladder Issues: Urgency, incontinence.
- Treatment: Pelvic floor therapy, bladder training.
Migraines: Often a trigger or overlap.
- Treatment: Migraine meds, trigger management.