FND: A Label - Not A Diagnosis!

FND (Functional Neurological Disorder) is a condition where people experience debilitating neurological symptoms - weakness, tremors, sensory changes - yet all the conventional scans and blood tests come back “normal.”  FND is not a diagnosis but a label that describes a set of symptoms that conventional medicine does not currently explain. This blog explores how a growing number of patients are slipping through the diagnostic net and coming to realise that more specialist tests are needed to uncover the real causes of their symptoms.  To find out more, please read on …

                   Common FND Symptoms

The symptoms of FND can be pretty scary and overlap with other chronic debilitating conditions that puzzle the NHS like CFS, ME, POTs (Postural Orthostatic Tachycardia giving dizziness/fainting in being upright), Long Covid etc.  They can include:

*Severe fatigue/exercise intolerance

*Tremors

*Numbness/tingling

*Sensitivity to light/sound/touch

*Autonomic nervous system dysfunction (dizziness, imbalance, fainting)

*Seizure-like episodes

                   Standard Tests for FND

The standard NHS “rule out” tests prior to receiving a FND diagnosis usually come back as “normal” and can include:

*MRI of brain and spine - to rule out stroke, MS, tumours, demyelination (damage to myelin sheath that protects nerves as in MS), structural problems, lesions.

*CT scan - usually if stroke or trauma is suspected.

*EEG (Electroencephalogram) - often done if seizures are reported; usually “normal” in FND despite seizure-like events.

*EMG (nerve conduction studies) - to check for peripheral neuropathies, neuro-muscular disorders - usually “normal.”

*Routine blood work: Full Blood Count, urea and electrolytes, liver function tests, thyroid, vitamin B12 and folate, inflammatory markers (CRP, ESR), autoimmune markers (ANA, ENA etc.)

*Lumbar puncture - typically “normal” in FND. 

All the above tests are designed to detect well-known disease processes or structural damage. In FND, they are usually “normal.” Patients may then be given a label of FND, not because they have no symptoms, but because conventional tests fail to reveal the symptom causes. This can leave patients feeling confused, invalidated and without a plan to go forward.

                  A Label With No Answers

For many people, receiving a diagnosis of FND because all their scans and blood work looks ‘normal” feels less of a diagnosis and more of a dismissal. 

Patients (and practitioners) may feel that the FND label implies their symptoms are “all in their mind” especially as FND sits uncomfortably between “can’t find anything physically wrong” and “therefore it must be psychological.”  The term “functional” is meant to describe a problem with how the nervous system works, not with its structure. But this nuance is rarely explained to patients.  

When I was a student at Oxford University in the late 70’s, I fell ill with a virus that severely affected my balance mechanism and caused chronic vertigo. Although the infectious component was clear from the blood tests, that trigger was ignored and the condition pronounced “functional” after the imaging of the time revealed no structural abnormality. In the opinion of the GP, continuing symptoms were “all in the mind.” According to my GP’s psycho-analysis,  I was subconsciously trying to “get out of doing my studies” or “didn’t get on with my mother” or some other nonsense.  Like so many patients today, I was shunted away from neurology towards psychiatry which does not address the biological causes of disease.  Fortunately, I never ended up on the dwindling spiral of psychiatric drugs that happens to so many people today. And fortunately, there was no FND label back then. I was one of the lucky ones who went outside the conventional routes and found the real psychical underlying causes of my symptoms. These happened to be a combination of dental poisoning, infection and food allergy.  When all three were addressed, I experienced a decline in symptoms and a return of health.

The real harm comes when FND is treated as the final answer, instead of an invitation to further exploration of the root causes.  Over time, lack of proper investigations means lost opportunities for successful treatments, lost quality of life, lost earnings.  Even worse, once FND is on the patient’s record, new symptoms may be dismissed as “just part of the FND.”  In the case of emerging new conditions like cardiac disease or even cancers, the consequences can be disastrous.

            A Trigger for Deeper Investigations

Rather than accepting FND as a final stop, clinicians should view it as a starting point for deeper investigations. If routine tests and scans fail to explain the disabling neurological symptoms, this should trigger curiosity, not closure.  That is why so many people turn towards the private sector to access lab tests that take a deeper dive into the immune system, and can accurately pinpoint active stealth infections and other conditions. This ultimately opens the door to successful treatments. 

The types of tests I have used with FND patients to help uncover the underlying causes of their symptoms include:

*Stealth infection screening (please see the blog on my website Falling Through The Cracks With Standard NHS Tests).

*Immune profiling 

*Metabolic/Mitochondrial panels

*Allergy screens

*Chemical/toxic burden screens

*Nutrient deficiency screens

*Dental examinations

*ENT examinations

*Structural assessments that go beyond MRI

By reframing FND as a “working description”, not a diagnosis, we can open the door to finding the underlying causes (which will be different for each person) and most importantly, offering some hope for improvement in health.

If you have been diagnosed with FND but need further help, please get in touch with the Good Health Clinic on goodhealthclinic@outlook.com to request a free 30 minute Enquiry Call or book an appointment. Please note that an Enquiry call is not a consultation but an exploratory call to see if this is a clinical approach you wish to pursue.To your very good health, 

Suzanne Jeffery (Nutritional Medicine Consultant)

M.A.(Oxon), BSc.(NMed), PGCE, GNC, BSEM, MNNA, CNHC

The Good Health Clinic at The Business Centre, 2, Cattedown Road, Plymouth PL4 0EG

Tel no: 07836 552936/ Answer phone: 01752 774755 

Disclaimer:

All advice given out by Suzanne Jeffery and the Good Health Clinic is for general guidance and informational purposes only.  All advice relating to other health professionals’ advice is for general guidance and information purposes only. Readers are encouraged to confirm the information provided with other sources.  Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by other practitioners and physicians. Suzanne Jeffery and the Good Health Clinic will not be liable for any direct, indirect, consequential, special, exemplary or other damages arising therefrom.