What is functional neurologic disorder?
Functional neurologic disorders — a newer and broader term that includes what some people call conversion disorder — feature nervous system (neurological) symptoms that can’t be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.
How common is functional neurologic disorder?
According to the National Organization for Rare Disorders, functional neurologic disorder is thought to occur in 14-22 cases per 100,000 people. While it can affect children, functional neurologic disorder is more common among adolescents and adults. People in rural settings and military personnel may be at higher risk of functional neurologic disorder than other groups.
Please discuss with your doctor for further information.
What are the symptoms of functional neurologic disorder?
The common symptoms of functional neurologic disorder are:
- Deafness or hearing difficulties
- Difficulty concentrating
- Difficulty swallowing
- Impaired movement
- Lack of responsiveness
- Loss of balance
- Loss of the senses, such as smell or touch
- Memory problems
- Pain in the muscles, skin, or joints
- Speech problems
- Tingling sensations in the skin
- Vision problems
Symptoms may come and go, or they may persist, and they can vary in their severity and location.
In most cases, symptoms resolve in a short time-period. However, in some people, they may continue for months or years and can hinder a person’s ability to work and carry out everyday activities.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes functional neurologic disorder?
The exact cause of functional neurologic disorders is unknown. Theories regarding what happens in the brain to result in symptoms are complex and involve multiple mechanisms that may differ, depending on the type of functional neurologic disorder.
Basically, parts of the brain that control the functioning of your muscles and senses may be involved, even though no disease or abnormality exists.
Symptoms of functional neurologic disorders may appear suddenly after a stressful event, or with emotional or physical trauma. Other triggers may include changes or disruptions in how the brain functions at the structural, cellular or metabolic level. But the trigger for symptoms can’t always be identified.
What increases my risk for functional neurologic disorder?
There are many risk factors for functional neurologic disorder, such as:
- Having a neurological disease or disorder, such as epilepsy, migraines or a movement disorder
- Recent significant stress or emotional or physical trauma
- Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder or certain personality disorders
- Having a family member with a functional neurologic disorder
- Possibly, having a history of physical or sexual abuse or neglect in childhood
- Women may be more likely than men to develop functional neurologic disorders.
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is functional neurologic disorder diagnosed?
Diagnosing functional neurologic disorder may take a long time, as the symptoms are not caused by an underlying physical condition and can mimic the symptoms of many other disorders. Doctors should not diagnose functional neurologic disorder on the basis that tests for other conditions have proved negative.
In many cases, both a neurologist and a psychiatrist will be involved in a diagnosis. A neurologist will help rule out underlying neurological conditions, while a psychiatrist can rule out other psychological causes and confirm a diagnosis of functional neurologic disorder.
Although there is no standard test to check for functional neurologic disorder, the tests commonly used for diagnosis include:
A health assessment and physical exam
A doctor will note any symptoms a person is experiencing and will ask about life changes, traumas, and major stressors. The doctor may also take a full medical history and family history.
A doctor may also carry out functional tests to check for normal reflexes, balance issues, and physical movements.
- Imaging tests
X-rays and MRI scans can identify whether symptoms are related to brain injuries or neurological abnormalities.
EEG (electroencephalogram) scans can track brain waves, allowing doctors to detect problems associated with the brain’s electrical activity, such as epilepsy.
- DSM Criteria
A psychiatrist will use the diagnostic criteria laid out in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make a diagnosis.
To be diagnosed with functional neurologic disorder, people:
- Must have one or more symptoms that affect their movement or senses and are outside of their conscious control
- Must not be able to attribute their symptoms to drug use or a physical or neurological condition
- May attribute their symptoms to a traumatic or stressful event (although this does not always have to be the case)
Due to the symptoms of functional neurologic disorder, there is the potential for the condition to be misdiagnosed.
A 2005 review suggests that the misdiagnosis rate for functional neurologic disorder has averaged at approximately 5 percent since 1970. Another report indicates that 41 percent of people with rare diseases will be misdiagnosed at least once.
Common misdiagnoses include:
- Guillain-Barre syndrome: A rare autoimmune disorder characterized by muscle weakness and pain.
- HIV or AIDS.
- Health anxiety: A psychological disorder characterized by excessive thoughts about having an undiagnosed illness.
- Lupus: An autoimmune disease with symptoms including fatigue and joint pain.
- Myasthenia gravis: A muscle weakness disorder.
- Neurological disorders: Disorders which affect the central nervous system, such as epilepsy, multiple sclerosis, polyneuropathy, and Parkinson’s disease.
- Spinal cord injury.
How is functional neurologic disorder treated?
Symptoms can resolve without treatment in some people with functional neurologic disorder, particularly after they are assured that their symptoms are not related to a more serious health condition.
However, treatments may be beneficial for those with:
- Other (co-occurring) psychological conditions
- Severe functional neurologic disorder symptoms
- Symptoms that are slow to resolve
- Recurrent symptoms
In general, doctors recommend a combination of treatments. These treatments include:
- People with functional neurologic disorder related to a stressful or traumatic event, or an underlying mental health condition, may benefit from working with a psychotherapist or psychologist. Some individuals with functional neurologic disorder undergo cognitive behavior therapy (CBT).
- Physical therapy. The physical symptoms of functional neurologic disorder, such as impaired movement or muscle weakness or pain, may be treated with physical therapy.
- Anti-anxiety drugs or antidepressants may help to treat the stress or anxiety that contributed to the onset of functional neurologic disorder.
- Transcranial magnetic stimulation (TMS). This treatment uses magnetic fields to stimulate certain parts of the brain. Some reports suggest TMS is beneficial for people with functional neurologic disorder, but there is limited evidence at this stage.
Engaging in activities that alleviate stress and anxiety, such as yoga, meditation, and progressive muscle relaxation, may be helpful for some people with functional neurologic disorder. Eating a balanced diet, getting enough sleep, fostering positive relationships, and maintaining a good quality of life also contribute to stress reduction.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage functional neurologic disorder?
The following lifestyles and home remedies might help you cope with this condition:
- Engaging in activities that alleviate stress and anxiety, such as yoga, meditation, and progressive muscle relaxation, may be helpful for some people with functional neurologic disorder.
- Eating a balanced diet
- Getting enough sleep
- Fostering positive relationships
- Maintaining a good quality of life
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: September 25, 2017 | Last Modified: September 25, 2017
Functional neurologic disorders/conversion disorder. http://www.mayoclinic.org/diseases-conditions/conversion-disorder/home/ovc-20323809. Accessed September 25, 2017.
Functional neurological symptom disorder: Diagnosis and treatment. https://www.medicalnewstoday.com/articles/318534.php. Accessed September 25, 2017.