Functional Neurological Disorder (FND)

What is FND?

Functional Neurological Disorder (FND) is a neurological condition that affects how the brain functions, disrupting the normal communication between the brain and body. This can result in a wide range of neurological symptoms that affect movement, sensation, speech, vision, swallowing and executive function/cognition. 

Unlike neurological conditions caused by structural damage to the brain or nervous system, such as stroke, brain tumours or multiple sclerosis, FND is a disorder of brain functioning. This means that while the brain’s structure is usually normal, the brain is not functioning as it should, leading to genuine neurological symptoms. 

FND is one of the most common conditions seen by neurologists and can affect people of all ages, including children and adolescents. An estimated 21,500 Australians (around 79 per 100,000 people) are living with FND. The Australian Institute of Health and Welfare (AIHW) notes this is likely to be an underestimate, as FND is often under-recognised and underdiagnosed. Symptoms may develop suddenly or gradually and can occur alongside other neurological conditions, including epilepsy, migraine, Parkinson’s disease and multiple sclerosis.  

Although the exact mechanisms behind FND are still being investigated, research suggests that changes in the brain networks involved in movement, attention, emotion and the processing of sensory information may contribute to symptoms. Importantly, the symptoms of FND are involuntary – they are not imagined, exaggerated or deliberately produced.

Historically, FND was poorly understood and was sometimes described using outdated terms such as “conversion disorder” or “psychogenic disorder”. Advances in neuroscience have led to a much better understanding of the condition, and FND is now recognised as a genuine neurological disorder that can improve with the right treatment and support.

Symptoms

FND can cause a wide range of neurological symptoms. Symptoms vary from person to person and may change over time. Some people experience only one symptom, while others experience several.

Common symptoms of FND include:

• Weakness or paralysis
• Tremor or other involuntary movements
• Difficulty walking or problems with balance (gait disorder)
• Functional seizures (also called dissociative or non-epileptic seizures)
• Numbness or altered sensation
• Speech difficulties
• Swallowing difficulties
• Vision problems, including blurred vision or temporary loss of vision
• Hearing changes
• Persistent dizziness
• Severe fatigue
• Problems with memory, concentration or thinking (“brain fog”)
• Pain
• Bladder or bowel problems

The symptoms of FND are genuine and can range from mild to severe. For some people, symptoms come and go, while for others they may be persistent and significantly affect daily life.

Many people with FND also experience other health conditions, such as migraine, chronic pain, chronic fatigue, anxiety or depression. These conditions may occur alongside FND and can influence a person’s symptoms and overall wellbeing.

Diagnosis

FND is usually diagnosed by a neurologist or another healthcare professional with expertise in neurological conditions.

Unlike many other neurological disorders, FND is diagnosed by identifying positive clinical signs during a neurological examination. These are specific patterns of symptoms and physical signs that are recognised as being characteristic of FND. This is known as making a positive diagnosis, meaning the diagnosis is based on what the clinician finds during the examination rather than simply ruling out other conditions.

Depending on a person’s symptoms, brain imaging or other investigations may be recommended to rule out structural neurological conditions, such as stroke or multiple sclerosis, or to identify other conditions that may occur alongside FND. Although these tests are often normal in people with FND, this does not mean that symptoms are imagined or “all in the head”. The symptoms are real and arise from changes in how the brain and nervous system function rather than structural damage.

FND can occur alongside other neurological conditions, including epilepsy, migraine, Parkinson’s Disease and multiple sclerosis. Having another neurological condition does not prevent someone from developing FND.

Receiving a clear explanation of the diagnosis is an important part of care. Understanding what FND is, how it affects the brain and body, and why symptoms occur can help people engage with treatment and improve their confidence in managing the condition.

Treatment and management

Although there is currently no single treatment that works for everyone with FND, many people improve with an accurate diagnosis, education about the condition and an individualised treatment plan.

Treatment depends on a person’s symptoms and is usually provided by a multidisciplinary team of healthcare professionals. This may include a neurologist, GP, physiotherapist, psychologist, occupational therapist, speech pathologist or other specialists, depending on the person’s needs.

Treatment may include:

• Education about FND and understanding the diagnosis
• Physiotherapy to improve movement, balance and physical function
• Occupational therapy to support daily activities and independence
• Psychological therapies, such as cognitive behavioural therapy (CBT), where appropriate
• Speech pathology for speech or swallowing difficulties
• Management of co-existing conditions, such as migraine, chronic pain, anxiety or depression
• Developing strategies to manage fatigue and other symptoms

Treatment is tailored to the individual, and no single approach is suitable for everyone. Early diagnosis and access to appropriate care may improve outcomes.

Outlook

The outlook for people with FND varies from person to person. Some people experience significant improvement or recovery, while others continue to have ongoing symptoms that require long-term management.

Recovery depends on many factors, including the type and severity of symptoms, how long symptoms have been present, access to appropriate treatment and the presence of other health conditions.

Receiving an accurate diagnosis early, together with education about FND and access to appropriate treatment, may improve outcomes. Even when symptoms persist, many people can learn strategies to manage their condition, improve their quality of life and regain independence.

Research into FND is continuing to improve our understanding of the condition and is helping to develop more effective approaches to diagnosis, treatment and rehabilitation.

Further information & support

If you have been diagnosed with FND, your healthcare team can provide information and support tailored to your individual needs.

You may also find the following organisations helpful:

• FND Australia Support Services – Information, education and support for people living with FND, their families and healthcare professionals – fndaus.org.au 
• FND Aus App – fndaus.org.au/fnd-app
• FND Hope International – Education, advocacy and peer support for people affected by FND – fndhope.org

If your symptoms change suddenly or you develop new neurological symptoms, seek medical advice promptly. In an emergency, call Triple Zero (000).

References:

1. Stone J. Functional symptoms in neurology: THE BARE ESSENTIALS. Practical Neurology. 2009;9(3):179-189. doi:10.1136/jnnp.2009.177204
2. Finkelstein SA, Diamond C, Carson A, Stone J. Incidence and prevalence of functional neurological disorder: a systematic review. Journal of neurology, neurosurgery, and psychiatry. 2024;96(4):jnnp-2024-334767. doi:10.1136/jnnp-2024-334767
3. AIHW (Australian Institute of Health and Welfare). Functional neurological disorder in Australia. AIHW, Australian Government. Updated December 5, 2025. Accessed 5 August, 2026. https://www.aihw.gov.au/reports/neurological-conditions/functional-neurological-disorders.
4. FND Australia Support Services Inc – fndaus.org.au
5. FND Hope – fndhope.org