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Functional Neurological Disorder: What You Need to Know

Imagine having neurological symptoms like tremors or even paralysis–only tests show nothing is wrong. This is the reality for many people with functional neurological disorder (FND).

FND is a challenging and frustrating condition, much like migraine. And research suggests there’s a link between the two. But does FND cause migraines? Keep reading to find out. We’ll cover the ins and outs of FND, including symptoms, causes, and its connection to migraine.

What is Functional Neurological Disorder?

Functional neurological disorder (FND) is a condition where the brain has trouble sending and receiving signals. Unlike many neurological conditions, FND isn’t due to problems with the brain’s structure. Instead, it stems from how the brain functions.

Think of your brain like a computer. With FND, the ‘hardware’ or brain structure is fine. The problem lies with the ‘software’ program running the computer.

These ‘software’ issues can lead to neurological symptoms that affect how you move, speak, walk, think, or feel.
Symptoms of FND

Symptoms of FND

FND symptoms vary from person to person. Some people may only have one or two symptoms. Others may have several.

FND symptoms may include:

Weakness or paralysis
Tremors, jerks, twitches, tics, or spasms
Trouble walking
Numbness
Seizures or episodes of uncontrolled shaking and loss of consciousness (not from epilepsy)
Memory issues
Trouble concentrating
Speech difficulties like slurred speech, stuttering, or loss of speech
Trouble swallowing
Dizziness
Visual symptoms like blurred vision, double vision, or sensitivity to light
Hearing problems

FND is also linked with several other symptoms and conditions, including:

Fatigue
Chronic pain
Insomnia
Migraines and other types of headaches
Irritable bowel syndrome (IBS)
Depression and anxiety
Urinary retention

trouble sleeping

Symptoms vary in intensity and may come and go or persist. They tend to get worse when given attention and decrease when distracted.

For some people, FND symptoms are short-lived. For others, they may go on for many years.

Like migraine, when these symptoms persist it can seriously interfere with your ability to function in day-to-day life.

What Causes FND?

It’s not entirely clear. Scientists suggest many psychological, social, and biological factors may play a role.

Stress or emotional or physical trauma may trigger FND for some people. But others may have no identifiable trigger at all.

Some research suggests the limbic system may be overly active in people with FND. The limbic system is the part of your brain in charge of emotions, memory, and learning.

Other studies show that the part of the brain involved in self-agency–the feeling of being in control of your life–may be impaired with FND.

Many things can increase the likelihood of developing FND.

Risk factors include:

Having another neurological condition such as migraine, epilepsy, or a movement disorder
Mental health conditions like depression, anxiety, PTSD, personality disorders, or dissociative disorders
History of sexual abuse, trauma, or neglect in childhood
Recent stress or high levels of ongoing stress

According to research, women are two to ten times more likely to develop FND than men. It often develops in the teenage years and rarely occurs in children under the age of five.

FND and Migraine: What’s the Link?

FND has many comorbidities, including migraine. In fact, one study found FND symptoms were twice as common among migraineurs.

The same study showed FND symptoms usually occur within 6 months or at the same time that migraine symptoms emerge. What’s more, treating migraine led to a decrease or remission in FND symptoms.

In addition, some symptoms of FND and migraine are quite similar. For example, visual disturbances are common with FND, as well as migraine with aura. And numbness, weakness, or paralysis can be a sign of FND or hemiplegic migraine.

Because of the similarities, the lines between the two conditions can get blurry.

Does FND Cause Migraines?

While there’s a connection between the two, no evidence shows that FND causes migraines.

However, research does suggest that migraine attacks may trigger FND seizures. In one scientific review of patients with FND seizures, migraine attacks triggered seizures in 65% of patients.

In addition, 73% of FND patients with follow-up data had reduced FND symptoms when treated with migraine prophylactic meds.

More research is certainly needed. But this does show an inextricable link between the two conditions.

How is FND Diagnosed?

FND can be tricky to diagnose since its symptoms mimic so many other conditions. Not to mention, there aren’t any tests or biomarkers that can confirm a FND diagnosis.

Since FND isn’t due to structural issues in the brain, tests like CT scans and MRIs typically come back normal. This may explain why, on average, it takes about 7 years to get a FND diagnosis.

Diagnosis is usually made by a neurologist or in some cases a psychiatrist. The doctor collects a thorough health history and does a physical examination, taking note of any signs of FND.

The neurological exam may include tests like Hoover’s sign to check for clinical signs.

The doctor will also compare your symptoms to the FND criteria in the DSM-V by the American Psychiatric Association, which are as follows:

One or more symptoms that affect your movement or senses
Symptoms can’t be explained by another neurological disorder or a mental health disorder
Symptoms cause significant impairment in school, work, or social life

Treatment for FND

FND treatment varies depending on the symptom profile. That said, education is the first step to successful treatment for all patients.

The more patients understand FND, that their symptoms are real, and that recovery is possible– the more motivated they’ll be in their treatment.

Many FND treatments aim to ‘retrain the brain’ to form new patterns. Treatments may include:

Cognitive behavioral therapy (CBT) can be helpful for FND, especially if it’s related to stress or trauma. CBT helps patients become aware of unhelpful thought patterns and how they relate to emotions and behaviors.
Physical therapy. Working with a physical therapist can help FND patients struggling with movement symptoms like weakness or gait issues. When done regularly, exercises can help retrain movement patterns and build strength.
Lifestyle changes. Stress reduction techniques like progressive muscle relaxation, meditation, yoga, or breathing exercises may benefit some people with FND. Since symptoms often increase with attention, distraction techniques like listening to music or talking to someone may also help.
Transcranial magnetic stimulation (TMS): TMS uses magnetic pulses to stimulate nerve cell activity in the brain. While more research is needed, some studies show TMS may improve FND symptoms.
Medication or nutritional support. FND isn’t typically treated with medications. However, if a patient has a comorbid condition like migraine, medication or nutritional support may help. As mentioned, studies show FND symptoms improve when migraine is treated. Migraine prophylactic meds like beta blockers are one option. But for those who prefer a more natural approach, nutritional support can help. Magnesium, riboflavin, and feverfew are all shown to support healthy neurological function. Migrelief contains all three and has been recommended by leading neurologists for over 25 years.

Takeaways

Functional neurological disorder is a puzzling condition that can severely disrupt your life. The good news is that FND is often reversible. While remission doesn’t happen overnight, it is possible with the right treatment. Retraining your brain you can help change symptoms affecting your movement, speech, or thinking.

Migraines are common among those with FND and can trigger symptoms. Keeping migraine in check–whether through healthy lifestyle habits or nutritional support–may help reduce FND symptoms.