A medical term that describes neurological symptoms that cannot be explained by neurological disorders or other diseases is called functional neurologic disorder (also known as conversion disorder). In any case, symptoms cause serious functioning problems and distress.
The symptoms a person experiences depend on the type of conversion disorder he/she has. In most cases, this disorder negatively affects the movement and senses (including the ability to walk, swallow, see, or hear). The symptoms occur differently among people and may come and go or be persistent and unfortunately, you cannot control them.
While the exact cause of the functional neurologic disorder is not known, experts think it is caused by a neurological condition, a stressful situation, or psychological or physical trauma but it is not sure. This disorder is related to how the brain functions more but not to the brain’s structure damage, which is usually caused by stroke, multiple sclerosis, infections, and other conditions.
In any case, early detection and treatment may reduce the symptoms, prevent complications, and help with recovery.
Symptoms
The symptoms that people with functional neurological disorders experience are different because they depend on the type of the condition, existing health conditions, and other factors. Check below some symptoms that negatively affect body function and movement:
- Weakness
- Paralysis
- Loss of balance
- Episodes of unresponsiveness
- Seizures or loss of consciousness (nonepileptic seizures)
Check also some symptoms that impact senses below:
- Speech problems (including inability to speak or slurred speech)
- Numbness
- Loss of the touch sensation
- Hearing problems
- Deafness
- Cognitive difficulties that involve concentration and memory
- Vision changes (such as double vision or blindness)
If any of the previous symptoms occur, immediately contact your doctor. Quick diagnosis and treatment are very important if symptoms occur due to a neurological disorder or another health condition.
Causes
However, it is not possible to determine the exact cause of functional neurologic disorders. The symptoms caused by changes in brain function are complex and involve different mechanisms and depend on the condition type.
Generally, the brain areas responsible for controlling the function of the muscles and senses are involved even if any condition or abnormality exists. The most common triggers of functional neurological disorder symptoms include stressful events, emotional or physical trauma, and changes in brain function at the metabolic, cellular, or structural level. In any case, not every time it is possible to determine the trigger of the symptoms.
Risk Factors
Check below some factors that may increase your risk of developing functional neurological disorder:
- Neurological diseases or disorders (including migraines, movement disorders, epilepsy, and others)
- Previous emotional or physical trauma or significant stress
- Mental health problems (such as anxiety or mood disorders, dissociative disorder, or personality disorders)
- Family history of neurological disorders
- History of physical or sexual abuse in childhood
In addition, women are more prone to develop this condition than men.
What Are The Potential Complications of Functional Neurological Disorder?
There are some symptoms of this disorder that if not treated may cause disability and poor quality of life, which is similar to other health conditions and diseases. Check below some complications that may occur in people with functional neurological disorders:
- Depression
- Sleeping disturbances (insomnia)
- Fatigue (extreme tiredness)
- Anxiety disorders (such as panic disorder)
- Pain
This article does not contain all possible complications, for more details, talk with your healthcare professional.
Diagnosis
There are no specific tests that may identify this condition. Thus, doctors diagnose this condition based on symptoms and specific tests (such as EEG or MRI). Diagnosis may involve multiple healthcare providers (such as neurologists, mental health professionals, and others).
In some cases, functional neurological disorders may be called according to the symptoms. For instance, if the condition causes movement problems, doctors call it functional weakness or functional gait disorder.
Healthcare professionals usually perform the following examinations during evaluation. For example:
- Physical examination – During this procedure, doctors will ask you questions about symptoms and medical history. They may also perform some tests to rule out other health conditions (such as neurological disorders) that cause similar symptoms.
- Psychiatric examination – You may be referred to a mental health professional. He/she usually asks questions about your behavior, feelings, and thoughts.
- Diagnostic criteria in the DSM-5 – Your doctor may compare the symptoms you experience to the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for diagnosis.
The criteria for the functional neurological disorder in the DSM-5 include:
- Symptoms that impact movement or senses
- unexplained symptoms either by a neurological condition or other disease or mental health problem
- The symptoms cause significant distress, and problems in social, work, or other regions
Treatment
Physicians often prescribe different treatment options for people with this disorder because it depends on existing health conditions, symptoms, the severity of the disease, and other factors. However, some people require a healthcare team that includes a neurologist, psychiatrist, or other mental health professionals, and physical, speech, and occupational therapists.
Medical Disorder Treatment
The following treatment options are usually recommended by doctors if the symptoms are caused by neurological conditions or other diseases. For example:
Therapies
- Occupational and physical therapy – These therapies are usually used to improve movement symptoms and prevent further complications. For instance, regular movement of legs or arms may reduce weakness, paralysis, and loss of mobility.
- Speech therapy – This therapy is effective in treating speech or swallowing problems.
- Stress management – The most common stress reduction options include progressive muscle relaxation, breathing exercises, physical activity, and exercise.
Medicines
Medicines that may help with symptoms of functional neurologic disorder are not available. In any case, physicians may recommend some antidepressants if you experience depression, mood disorders, pain, or insomnia (sleeping problems).
Other Treatments
Check below some psychiatric treatment options often prescribed by doctors for people with functional neurological disorders:
- Cognitive behavioral therapy (CBT) – This is an effective treatment option that helps become aware of negative or inaccurate thinking and manage better stressful events in your life.
- Treatments for other mental health problems – If you have other mental diseases, the symptoms of functional neurological disorders may worsen. That’s why doctors may prescribe additional treatments.
What are the primary symptoms of functional neurological disorder?
- Unresponsiveness episodes
- Swallowing problems
- Loss of balance
- Weakness
- Paralysis
- Abnormal movement (such as walking problems or tremors)
- Seizures
If any of the previous symptoms occur in a loved one, immediately visit a doctor.
What are the most effective medications that reduce symptoms of functional neurological disorders?
To lessen the symptoms caused by this disorder, doctors often prescribe sedative medications (including Benzodiazepines, Baclofen, and opiates). However, adverse reactions to previous medicines may be quite severe. Discuss with your healthcare professional about the benefits and risks before using any of them.
What health conditions may be mistaken for a functional neurological disorder?
These include:
- Fibromyalgia
- Multiple sclerosis
- Sciatica
- Carpal tunnel syndrome
- Epilepsy
If you have additional questions, ask your healthcare professional.
