FND Myths & Misunderstandings

Myth: FND is only diagnosed after everything else is ruled out.

Fact: FND is diagnosed using positive clinical features. Depending on the symptoms, clinicians may identify signs such as Hoover’s sign or tremor entrainment that provide positive evidence supporting the diagnosis. FND is not diagnosed simply because tests for other conditions are normal.

Myth: FND can’t occur alongside other disorders.

Fact: FND can occur alongside other neurological conditions, including epilepsy, migraine, multiple sclerosis, and Parkinson’s disease. Having another neurological diagnosis does not rule out FND, and clinicians should consider both when evaluating symptoms.

Myth: The symptoms are too strange to be neurological.

Fact: FND symptoms can resemble symptoms seen in other neurological conditions. Clinicians identify FND using characteristic positive clinical features, such as specific patterns of inconsistency or changes with attention or movement, depending on the symptom being assessed.

Myth: Seizures, paralysis, and speech issues must come from separate causes.

Fact: FND can cause different types of neurological symptoms, including functional seizures, weakness or paralysis, movement difficulties, speech symptoms, and sensory changes. A person may experience one type of symptom or several. Fatigue, pain, sleep difficulties, and cognitive symptoms are also commonly reported by people with FND.

Myth: People with FND are choosing what is happening.

Fact: FND symptoms are genuine and experienced as involuntary. People with FND are not deliberately producing or choosing their symptoms. FND should be distinguished from conditions in which symptoms are intentionally produced or feigned.

Myth: Testing is unnecessary once FND is considered.

Fact: FND is diagnosed through clinical assessment and positive features that support the diagnosis. Tests such as imaging, bloodwork, or other investigations may still be appropriate when clinicians need to evaluate other possible or coexisting conditions. The investigations needed depend on the person’s symptoms and clinical circumstances.

Myth: Labeling symptoms as FND is always safer.

Fact: Misdiagnosis in either direction can be harmful. Missing FND can delay appropriate care, while incorrectly attributing symptoms from another condition to FND can also delay needed diagnosis or treatment. New or changing symptoms deserve appropriate clinical evaluation.

Myth: FND is only caused by stress or trauma.

Fact: FND is not explained simply by stress, trauma, or another psychological factor. Psychological stress or trauma is not required for an FND diagnosis. Biological, psychological, and social factors may differ from person to person, and the factors contributing to FND are not the same for everyone.

Myth: FND is short-term and easily resolved.

Fact: Recovery varies widely. Some people experience substantial or full recovery, while others continue to experience long-term symptoms or disability. Appropriate treatment and support should be individualized, and responses to currently available treatments vary.

Myth: Therapy is the only option.

Fact: Psychological therapy is not the only treatment used for FND. Depending on a person’s symptoms and needs, treatment may include education about FND, physiotherapy, occupational therapy, psychological therapy, and management of coexisting symptoms or conditions. Treatment should be individualized and may involve professionals from different disciplines.