Functional Neurological Disorders

Functional Neurological Disorders (FND) affect up to 300,000 people in the U.S. and often impact quality of life if untreated. At GEM Neurology, PLLC in Clinton, Tennessee, Dr. Luis E Zayas—a board-certified neurologist in epilepsy, with fellowship training in movement disorders and a background as a physical therapist—offers both first and second opinions for FND diagnosis. Dr. Zayas ensures accurate diagnoses and guides patients toward effective treatments, including physical therapy, psychotherapy, and psychiatric support.

Call our office today to schedule an evaluation.

What are functional neurological disorders?

Functional neurological disorders appear when the brain has difficulty sending and receiving signals effectively despite having no damage to the brain or nerves. These conditions can cause bothersome and crippling symptoms when left untreated, and there’s no known cause. 

What are the symptoms of functional neurological disorders?

Functional Neurological Disorder (FND) presents with a range of symptoms that don’t follow typical neuroanatomy, often showing inconsistencies during exams. Sensory disturbances, for example, don’t align with standard nerve pathways, and motor deficits may vary in presentation. Common symptoms include:

• Motor Symptoms: Functional dystonia, bizarre gait abnormalities, tremors, and jerky movements
• Sensory Changes: Numbness or altered sensations without typical patterns
• Seizure-like Episodes: Non-epileptic seizures (PNES)
• Speech & Swallowing Issues: Slurred speech or swallowing difficulty
• Cognitive & Emotional Symptoms: Memory issues, confusion, anxiety, and depression

For an expert FND evaluation, contact GEM Neurology today.

What are the risk factors for functional neurological disorders?

Functional Neurological Disorder (FND) risk factors can include:

• Psychological Stress: Trauma or life stressors, although FND often occurs without these and they are not required for diagnosis.
• Personality Traits: Sensitivity to stress, perfectionism
• Medical History: Prior neurological issues (e.g., migraines, epilepsy, panic attacks)
• Psychiatric Conditions: Anxiety, depression
• Frequent Medical Encounters: High exposure to medical settings or family neurological history

Understanding these factors helps with early diagnosis and management. Contact GEM Neurology for a specialized FND evaluation.

How are functional neurological disorders diagnosed?

Functional Neurological Disorders (FND) are diagnosed based on positive clinical findings rather than ruling out other conditions. Specific criteria guide the diagnosis, which is confirmed by unique signs observed during the neurological exam. For functional seizures (PNES), admission to an epilepsy monitoring unit may be necessary, as these seizures lack typical brain activity patterns on EEG.

For a professional FND evaluation and diagnosis, contact GEM Neurology.

How are functional neurological disorders treated?

Functional Neurological Disorder (FND) is best managed with a multidisciplinary approach focused on physical and psychological therapies. There is no specific medication for FND itself, though treatment may include medication if the patient also experiences anxiety, depression, or other mental health conditions. Here are the top FND treatment options based on the latest evidence:

1. Specialized Physical Therapy for FND
Physical therapy for FND focuses on movement retraining to help patients regain control and reduce symptoms like tremors, functional dystonia, and abnormal walking. Neurologically-informed physical therapy has shown significant benefits, supporting improved mobility and quality of life.

2. Cognitive Behavioral Therapy (CBT) for FND Management
Cognitive Behavioral Therapy (CBT) is a primary psychological treatment for FND, especially for patients experiencing psychogenic non-epileptic seizures (PNES). CBT helps patients reshape unhelpful thought patterns, offering effective symptom control. For some individuals, trauma-informed CBT may also be beneficial.

3. Lifestyle Adjustments and Occupational Therapy
Managing lifestyle factors, such as stress, sleep, and physical activity, is essential in FND care. Occupational therapy can help adapt daily activities, conserve energy, and minimize symptom impact, creating a balanced approach to FND management.

4. Speech and Cognitive Rehabilitation
For patients with functional speech or cognitive symptoms, speech therapy and cognitive rehabilitation improve communication skills and cognitive function, supporting better daily interactions and quality of life.

At GEM Neurology, each FND treatment plan is personalized to the patient’s needs, enhancing long-term outcomes. Contact GEM Neurology today for a specialized FND evaluation.