Overview

Functional neurologic disorder — a newer and broader term that includes what some people call conversion disorder — features nervous system (neurological) symptoms that can't be explained by a neurological disease or other medical condition. However, the symptoms are real and cause significant distress or problems functioning.

Signs and symptoms vary, depending on the type of functional neurologic disorder, and may include specific patterns. Typically, this disorder affects your movement or your senses, such as the ability to walk, swallow, see or hear. Symptoms can vary in severity and may come and go or be persistent. However, you can't intentionally produce or control your symptoms.

The cause of functional neurologic disorder is unknown. The condition may be triggered by a neurological disorder or by a reaction to stress or psychological or physical trauma, but that's not always the case. Functional neurologic disorder is related to how the brain functions, rather than damage to the brain's structure (such as from a stroke, multiple sclerosis, infection or injury).

Early diagnosis and treatment, especially education about the condition, can help with recovery.


Symptoms

Signs and symptoms of functional neurologic disorder may vary, depending on the type of functional neurological symptoms, and they're significant enough to cause impairment and warrant medical evaluation. Symptoms can affect body movement and function and the senses.

Signs and symptoms that affect body movement and function may include:

  • Weakness or paralysis
  • Abnormal movement, such as tremors or difficulty walking
  • Loss of balance
  • Difficulty swallowing or feeling "a lump in the throat"
  • Seizures or episodes of shaking and apparent loss of consciousness (nonepileptic seizures)
  • Episodes of unresponsiveness

Signs and symptoms that affect the senses may include:

  • Numbness or loss of the touch sensation
  • Speech problems, such as the inability to speak or slurred speech
  • Vision problems, such as double vision or blindness
  • Hearing problems or deafness
  • Cognitive difficulties involving memory and concentration

When to see a doctor

Seek medical attention for signs and symptoms that concern you or interfere with your ability to function. If the underlying cause is a neurological disease or another medical condition, quick diagnosis and treatment may be important. If the diagnosis is functional neurologic disorder, treatment may improve the symptoms and help prevent future problems.


Causes

The exact cause of functional neurologic disorder is unknown. Theories regarding what happens in the brain to result in symptoms are complex and involve multiple mechanisms that may differ, depending on the type of functional neurological symptoms.

Basically, parts of the brain that control the functioning of your muscles and senses may be involved, even though no disease or abnormality exists.

Symptoms of functional neurologic disorder may appear suddenly after a stressful event, or with emotional or physical trauma. Other triggers may include changes or disruptions in how the brain functions at the structural, cellular or metabolic level. But the trigger for symptoms can't always be identified.


Risk factors

Factors that may increase your risk of functional neurologic disorder include:

  • Having a neurological disease or disorder, such as epilepsy, migraines or a movement disorder
  • Recent significant stress or emotional or physical trauma
  • Having a mental health condition, such as a mood or anxiety disorder, dissociative disorder or certain personality disorders
  • Having a family member with a neurological condition or symptoms
  • Having a history of physical or sexual abuse or neglect in childhood

Females may be more likely than males to develop functional neurologic disorder.


Complications

Some symptoms of functional neurologic disorder, particularly if not treated, can result in substantial disability and poor quality of life, similar to problems caused by medical conditions or disease.

Functional neurologic disorder may be associated with:

  • Pain
  • Anxiety disorders, including panic disorder
  • Depression
  • Insomnia
  • Fatigue

Jan 11, 2022

  1. Conversion disorder (functional neurological symptom disorder). In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. American Psychiatric Association; 2013. https://dsm.psychiatryonline.org. Accessed Oct. 27, 2021.
  2. Aminoff MJ, et al.eds. Functional (psychogenic) neurologic disorders. In: Aminoff's Neurology and General Medicine. 6th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Oct. 27, 2021.
  3. AskMayoExpert. Functional neurologic disorder. Mayo Clinic. 2020.
  4. Functional neurologic disorder. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Functional-Neurologic-Disorder. Accessed Oct. 27, 2021.
  5. Gilmour GS, et al. Management of functional neurological disorder. Journal of Neurology. 2020; doi:10.1007/s00415-020-09772-w.
  6. Bennett K, et al. A practical review of functional neurological disorder (FND) for the general physician. Clinical Medicine. 2021; doi:10.7861/clinmed.2020-0987.
  7. Fobian AD, et al. A review of functional neurological symptom disorder etiology and the integrated etiological summary model. Journal of Psychiatry and Neuroscience. 2019; doi:10.1503/jpn.170190.
  8. O'Neal MA, et al. Treatment for patients with a functional neurological disorder (conversion disorder): An integrated approach. American Journal of Psychiatry. 2018; doi:10.1176/appi.ajp.2017.17040450.
  9. Sim LA (expert opinion). Mayo Clinic. Nov. 16, 2021.

CON-XXXXXXXX

Show the heart some love!

Help us advance cardiovascular medicine.