What's Happening?
Functional neurological disorder (FND) is a prevalent condition affecting the nervous system, often seen in emergency care and outpatient neurology clinics. Despite its commonality, affecting 10-22 people per 100,000 annually, FND is frequently under-recognized and misunderstood by healthcare professionals. This leads to delays in diagnosis and treatment, with patients sometimes being accused of exaggerating or faking their symptoms. The disorder does not appear on routine brain imaging, as it results from dysfunction in the processing of information between brain networks, rather than damage to the nervous system. Symptoms can include paralysis, abnormal movements, sensory issues, and cognitive symptoms like brain fog. Treatment typically involves a multidisciplinary approach, including physiotherapy and psychological support, and accurate information about the condition is crucial for recovery.
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Why It's Important?
The underdiagnosis and misunderstanding of FND have significant implications for patients, who may experience prolonged suffering and disability due to delayed treatment. This condition is more common than multiple sclerosis, yet lacks the same level of awareness and understanding among healthcare providers. The historical stigma associated with FND, rooted in the legacy of hysteria, contributes to ongoing biases and inadequate care, particularly affecting women. Increasing awareness and education among medical professionals are essential to improve diagnosis and treatment, reducing stigma and enhancing patient outcomes. Patient-led organizations are advocating for better health systems and research to establish a new standard of care.
What's Next?
Efforts to improve the recognition and treatment of FND are underway, with growing interest in research and new treatment approaches, including specialist physiotherapy and non-invasive brain stimulation. Patient advocacy groups are working to unite patients, families, clinicians, and researchers to advance care standards globally. Continued education for healthcare professionals is crucial to increase confidence and knowledge in managing FND, potentially leading to earlier diagnosis and more effective treatment strategies.
Beyond the Headlines
The historical context of FND, linked to the concept of hysteria, highlights the ethical and cultural dimensions of medical bias and stigma. Addressing these biases is critical to ensuring equitable treatment and recognition of FND as a legitimate medical condition. The development of new treatment approaches and increased advocacy may lead to long-term shifts in how neurological disorders are perceived and managed.
