Overview
Functional neurological symptoms (FND) are genuine physical symptoms that arise from a problem in how the nervous system functions, without structural damage to the brain or nerves.
Anxiety, in turn, can present with intense physical symptoms that mimic neurological disease. In both cases the symptoms are not ‘imaginary’ — they simply have a different mechanism.
Symptoms
Symptoms vary in intensity and may fluctuate through the day. They often worsen with fatigue or stress and improve when attention is distracted.
- Dizziness, unsteadiness or a feeling of faintness
- Numbness, tingling or weakness in a limb
- Tremor or involuntary movements
- Functional (non-epileptic) seizures
- Brain fog, difficulty with concentration or memory
Causes & triggers
A significant psychological burden often coexists, and symptoms may be triggered by physical precipitating factors (e.g. an infection or injury). Understanding the mechanism helps with acceptance and treatment.
Diagnosis
The diagnosis is not necessarily one of exclusion. It is also based on positive clinical signs during the neurological examination that point to a functional mechanism.
Where needed, targeted tests are requested to rule out other conditions, without unnecessary over-investigation that increases anxiety.
Treatment approach
Treatment begins with a clear, understandable explanation of the diagnosis — one of the most important therapeutic steps.
The plan is individualised and may include FND-specific physiotherapy, psychological support or cognitive-behavioural therapy, anxiety-management techniques and, where indicated, medication.
When to see a neurologist
- Sudden, persistent weakness, slurred speech or visual disturbance — rule out acute causes first (call emergency services)
- Symptoms that significantly affect your daily life or work
- Recurrent episodes of dizziness, tremor or ‘blanking out’ without a clear explanation
- Marked anxiety with physical symptoms that worry you