Skip to main content
Neuregen · Scottsdale, Arizona · 866-999-1177
Providers – Refer Your Patient
Neuregen Integrative Brain Health

Functional Neurological Disorder (FND)

From 
"Mystery
Diagnosis" 
to 
New Hope &
Freedom.

 

Neuregen's
'Mind-Body-Brain'-
based Approach to Functional Neurological Disorder (FND) & "Mystery" Brain Conditions.

1. What is Functional Neurological Disorder? 
 

Functional Neurological Disorder (FND) involves genuine neurological symptoms associated with altered nervous-system functioning. Symptoms may affect movement or sensation and can include functional seizures. Diagnosis relies on positive clinical features, not simply on symptoms being unexplained or tests being normal. Other neurological conditions can coexist (Espay et al., 2018).

​

Frequency estimates vary by population, subtype, and diagnostic methods. FND is an important cause of disability encountered in neurological practice; annual new cases and the total number of people living with FND describe different measures.

​

FND can occur across ages and genders. Individual symptoms, medical history, and examination findings matter more for diagnosis than demographic assumptions.

​

Anxiety, depression, trauma, or other mental health concerns can coexist with FND and may deserve treatment in their own right. They are not required for the diagnosis, and their presence alone does not establish FND (Espay et al., 2018).

 

Care should consider a person’s neurological symptoms, daily function, and mental health without assuming that symptoms are imagined or deliberately produced. A clear explanation of the diagnosis is an important part of care (Carson et al., 2016).

 

2. What Causes Functional Neurological Disorder?  
 

Imaging studies investigate brain networks involved in movement, attention, emotion, and the sense of control over actions. Findings help researchers explore FND, but they do not provide a routine stand-alone diagnostic scan (Aybek & Vuilleumier, 2016).

 

Several models seek to explain how attention, expectations, and movement control can interact in FND. A Bayesian account is one research model, not a complete explanation for every patient (Edwards et al., 2012).

 

Psychological and brain-based models address different aspects of FND. Emotional processing may be relevant for some people, but a history of stress or trauma should not be presumed or treated as a universal cause (Pick et al., 2019).

 

3. Disability and Functional Impairment in FND  
 

FND symptoms can be disabling, affecting walking, work, relationships, and daily activities. Symptoms may fluctuate. Care should address safety, function, and the person’s own priorities, including any coexisting medical problems.

 

People may also experience fatigue, pain, anxiety, or depression. These concerns deserve assessment rather than an assumption that every symptom has the same cause.

 

4. Integrative Psychiatry and Brain-based Treatment Approaches for Functional Neurological Disorder (FND)
 

Treatment may include neurological care, rehabilitation, and psychological support according to the symptoms and needs of the individual. Research on one FND subtype cannot automatically be applied to every other subtype.

 

Hypnosis has been studied as a way to investigate changes in perception and motor experience. That research does not establish that hypnosis is particularly effective for FND; its clinical role needs further investigation (Oakley & Halligan, 2009).

 

In addition to psychological interventions, neurorehabilitation approaches are being explored for FND. These treatments involve retraining the brain to improve movement and function, often through physiotherapy combined with psychological support. 

 

5. What the Treatment Evidence Shows

A review of FND care describes promising evidence for specific rehabilitation and psychological interventions, while noting limits in clinical trial evidence (Espay et al., 2018). Treatment goals and expected benefits should be discussed for the person’s specific symptoms.

 

In the CODES trial of adults with dissociative seizures, CBT added to standardized medical care did not significantly reduce the primary outcome of monthly seizure frequency at 12 months. Some secondary outcomes improved. This supports a careful discussion of goals and uncertainty rather than a promise that psychotherapy stops seizures (Goldstein et al., 2020).

​

6. Individualized Care at Neuregen in Scottsdale, AZ

At Neuregen, the care plan is based on the person’s presentation and goals. The team discusses which services it can provide, when coordination with other clinicians is needed, and the benefits, risks, and evidence relevant to each proposed option.

​

7. Conclusion  

FND symptoms are real. A positive diagnosis, understandable explanation, and individualized care can help people make informed decisions. Outcomes vary, and research continues to clarify which treatments help which symptoms.

 

References

​

Aybek, S., & Vuilleumier, P. (2016). Imaging studies of functional neurologic disorders. Handbook of Clinical Neurology, 139, 73–84. https://doi.org/10.1016/B978-0-12-801772-2.00007-2

​

Carson, A., Lehn, A., Ludwig, L., & Stone, J. (2016). Explaining functional disorders in the neurology clinic: a photo story. Practical Neurology, 16(1), 56–61. https://doi.org/10.1136/practneurol-2015-001242

​

Edwards, M. J., Adams, R. A., Brown, H., Pareés, I., & Friston, K. J. (2012). A Bayesian account of “hysteria”. Brain, 135(11), 3495–3512. https://doi.org/10.1093/brain/aws129

​

Espay, A. J., Aybek, S., Carson, A., Edwards, M. J., Goldstein, L. H., Hallett, M., & Stone, J. (2018). Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurology, 75(9), 1132-1141. https://doi.org/10.1001/jamaneurol.2018.1264

​

Goldstein, L. H., Robinson, E. J., Mellers, J. D. C., et al. (2020). Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. The Lancet Psychiatry, 7(6), 491–505. https://doi.org/10.1016/S2215-0366(20)30128-0

​

Oakley, D. A., & Halligan, P. W. (2009). Hypnotic suggestion and cognitive neuroscience. Trends in Cognitive Sciences, 13(6), 264–270. https://doi.org/10.1016/j.tics.2009.03.004

 

 

Pick, S., Goldstein, L. H., Perez, D. L., & Nicholson, T. R. (2019). Emotional processing in functional neurological disorder: a review, biopsychosocial model and research agenda. Journal of Neurology, Neurosurgery & Psychiatry, 90(6), 704–711. https://doi.org/10.1136/jnnp-2018-319201

 

Stone, J., LaFrance, W. C., Levenson, J. L., & Sharpe, M. (2010). Issues for DSM-5: conversion disorder. American Journal of Psychiatry, 167(6), 626–627. https://doi.org/10.1176/appi.ajp.2010.09101440

 

Stone, J. (2016). Functional neurological disorders: the neurological assessment as treatment. Practical Neurology, 16(1), 7–17. https://doi.org/10.1136/practneurol-2015-001241

​

Symptoms and signs of Functional Neurological Disorder (FND):
 

  • Motor symptoms:

    • Weakness or paralysis (e.g., limb weakness)

    • Abnormal movements (e.g., tremors, dystonia, or tics)

    • Gait problems (e.g., difficulty walking or abnormal walking patterns)

    • Seizure-like episodes (non-epileptic seizures or psychogenic nonepileptic seizures, PNES)

    • Speech disturbances (e.g., slurred speech or inability to speak)

​​

  • Sensory symptoms:

    • Numbness or tingling (especially in limbs or face)

    • Loss of sensation in specific body parts

    • Visual disturbances (e.g., blurred vision, double vision, or temporary blindness)

    • Hearing loss or ringing in the ears.

​​

  • Cognitive and psychological symptoms:

    • Memory issues or cognitive "fog"

    • Difficulty concentrating

    • Dissociation (feeling detached from oneself or surroundings)

    • Emotional dysregulation (e.g., increased anxiety, depression, or emotional instability).

​​

  • Other common symptoms:

    • Fatigue and general malaise

    • Persistent pain without a clear physical cause

    • Symptoms often worsen with stress or emotional distress


These symptoms vary widely between individuals and may fluctuate in severity over time.

Overview of Neuregen in Scottsdale, AZ 
Treatment for Functional Neurological Disorder

Overview of
Process

Neuregen begins with an individualized assessment of neurological symptoms, daily function, and mental health concerns. The plan may combine rehabilitation and psychological care, with clear discussion of evidence and uncertainty.

Step 1:
Comprehensive Assessment

Assessment considers the history, neurological examination, positive clinical signs, and relevant alternative or coexisting conditions. Tests are selected when clinically indicated. Normal imaging alone does not confirm FND (Espay et al., 2018).

Step 2:
Personalized Rehabilitation Program Initiated

The plan reflects the person’s symptoms, goals, and preferences. The options below have different evidence bases and are not interchangeable.

Medical Hypnosis for FND: Evidence Limitations

Hypnosis may be discussed as an adjunct in selected cases. The cited cognitive-neuroscience research does not prove clinical effectiveness for FND, and benefit should not be promised (Oakley & Halligan, 2009).

Rehabilitation for Functional Motor Symptoms

Rehabilitation may focus on movement, daily activities, and self-management, with psychological support when appropriate. Treatment is tailored to the symptoms and functional goals; improvement and the amount of therapy needed vary (Espay et al., 2018).

Ketamine for FND: Investigational Evidence

A 2026 systematic review found that the evidence consists predominantly of uncontrolled case reports and small series and is insufficient to establish ketamine or esketamine efficacy for FND. Benefits seen in depression cannot be assumed to establish benefits for FND (Tamilson et al., 2026). Read the systematic review. Any proposed use requires an individualized discussion of uncertainty, risks, and alternatives.

Stellate Ganglion Block and FND

The references on this page do not establish that stellate ganglion block treats FND. Findings for other conditions should not be extrapolated to FND. If a procedure is considered for a separate co-occurring condition, its indication, evidence, risks, and alternatives should be discussed separately.

Psychotherapy for Functional Seizures

Psychotherapy may help with coping, distress, and aspects of functioning. The CODES trial found benefits in some secondary outcomes but no significant difference in its primary seizure-frequency outcome. These findings should not be presented as a guaranteed response or generalized to all FND presentations (Goldstein et al., 2020).

Neuromodulation: Individual Evidence Review

Any proposed brain-stimulation intervention requires a discussion of the specific technique, indication, evidence, risks, and alternatives. This page does not establish neuromodulation as an effective treatment for FND.