5/21/2023 0 Comments Functional neurological disorder“It was thought that some psychic distress was being converted into a physical symptom,” explains Santhouse. The diagnosis also required a connection to a psychological stressor. Many of these symptoms are also present in other neurological conditions, such as Parkinson’s, MS, epilepsy, or stroke, but the underlying causes are different.īack when it was known as conversion disorder, FND was thought of as a diagnosis of exclusion, made only when tests had ruled out all other possible diseases. Symptoms of FND can include weakness or paralysis, abnormal movements, changes in speech, difficulty swallowing, seizures, numbness, and sensory challenges, such as difficulty seeing, smelling, or hearing. These symptoms are not made up or imagined.” “We have a far more sophisticated understanding now of what this is. “People thought these patients were constitutionally weak, exaggerating their symptoms, or making it up,” says London-based psychiatrist Alastair Santhouse, MA, FRCP, FRCPsych, author of Head First: How the Mind Heals the Body. Through the centuries, FND has been given various names, including “conversion disorder” and “hysteria.” Stigma has often followed it. He also gained access to emerging insights and treatments that have made a world of difference to his recovery. Yet as Martin researched FND, he started to understand the condition in a new way. “I thought they were saying I had a delusion of illness - like I had inflicted it on myself or there was no substantial disability beyond me thinking that I had one. “I hit a real emotional low point,” says Martin. Therein lies the conceptual challenge of the disease: It is rooted in the brain, but the brain is healthy it’s a signaling problem, not a structural one. Imagine the brain as a computer with FND, it’s running faulty software. Yet FND does represent “changes in the software circuitry of the brain,” says Jeremy Schmoe, DC, DACNB, director of the Functional Neurology Center in Minnetonka, Minn. With functional neurological disorders, it’s running faulty Software. It’s not a “hardware” problem, as in stroke or multiple sclerosis (MS). But the way it communicates - with itself, the body, and the outside world - has gone awry. The FND-affected brain looks healthy on MRI studies or CT scans. “I think their team actually knew what I had just by looking at my application,” he says. Their diagnosis was clear: Martin had functional neurological disorder (FND). A team of specialists from multiple disciplines examined him. In a last-ditch effort, he applied to the highly selective National Institutes of Health Undiagnosed Diseases Program, and was accepted in 2017. “I just could not get referred anywhere else.” “Eventually, I ran out of places to go,” he says. Some of the doctors thought he might have an undiscovered genetic condition that could prove fatal, a hypothesis that only increased Martin’s alarm. He visited five major medical centers, but no one could figure out what was wrong. His quest for a diagnosis took him to neurologists, rheumatologists, allergists, and immunologists. “There were months at a time when I couldn’t speak.” I couldn’t use my hands for more than grasping weakly,” he recalls. “At my most disabled, I was in a wheelchair, unable to walk. Then they began to spread.ĭuring the next few years, Martin lost function in his vocal cords and his limbs. But Martin (not his real name), who was in his mid-20s, found that the resulting disabilities - shooting pain, weakness, and speaking difficulties - persisted. None of them were terribly serious, and they healed on their own. In 2010, Gavin Martin suffered a series of injuries at his workplace.
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