“Stop faking!” Imagine hearing those words moments after your doctor diagnosed you with, say, a stroke or a brain tumor. That sounds absurd but for many people diagnosed with a condition called functional neurological disorder , this is exactly what happens.
Historically, FND was called “conversion disorder.” The term came from the belief that traumatic stress “converted” into functional neurological symptoms via psychological mechanisms. This is no longer how we understand FND. Stress and trauma can play a part. In fact, some researchers believe the unique global stressors our society faced during the COVID pandemic increased some people’s susceptibility to the condition. But not every person with FND has experienced a traumatic event.
Clinicians are also finding better ways to diagnose FND. In the past, neurologists considered conversion disorder to be a diagnosis of exclusion, meaning a diagnosis was made after ruling out structural neurological abnormality through examination, radiological imaging, laboratory studies and neurophysiological testing such as electroencephalography . As a result, many patients with FND felt their doctor had told them what they didn’t have, not what they did have.
This reaction has damaging consequences. In January a collaboration of researchers at the University of Sheffield in England, Arizona State University and the Northeast Regional Epilepsy Group laid out case studies and other evidence that clinicians’ unsupportive response to their patients may contribute to a sense of shame in people who are already suffering psychologically from their functional symptoms. In fact, being prone to shame may itself be an additional risk factor for FND.
MPLerario D'oh!
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