Twenty-six-year-old Sneha was terrified. One morning, while getting ready for work, she suddenly found that her right leg would not move properly. She struggled to walk and felt as if the leg had 'stopped listening to her brain. Her family rushed her to a hospital, fearing a stroke. But the MRI scan was normal. Blood tests were normal, too.
A few days later, the weakness improved slightly, but she began experiencing tremors in her hand and episodes where she felt unable to speak properly. Different doctors gave different opinions. Some suggested anxiety. Others hinted that the symptoms were "all in her mind.” One physician even told her bluntly, “Nothing is wrong with you.”
The symptoms, however, were very real. Sneha stopped going to work. Friends drifted away because they thought she was exaggerating. Her confidence collapsed. The repeated normal reports only increased the family’s confusion.
Finally, months later, she consulted a neurologist familiar with a condition called Functional Neurological Disorder (FND). For the first time, someone explained what was happening to her in a scientific, respectful, and compassionate way.
With proper treatment, including physiotherapy, education about the illness, stress management, and psychological support, Sneha gradually improved. Within months, she was walking normally again and slowly rebuilding her life. Her story is more common than many people realize.
What is a functional neurological disorder?
Functional neurological disorder (FND) is a genuine neurological condition in which patients develop symptoms such as weakness, tremors, abnormal movements, blackouts, speech problems, walking difficulty, numbness, or even seizures, but routine scans and tests may appear normal.
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This does not mean the symptoms are fake or imagined. The brain is functioning abnormally, even though there may not be visible structural damage like a tumor or stroke. Experts today increasingly describe FND as a 'software problem' rather than a 'hardware problem' of the nervous system.
How common is FND?
FND is one of the commonest conditions seen in neurology clinics. It can occur at any age but is seen more commonly in young and middle-aged adults. Women appear to be affected more often than men, although FND can occur in both sexes and even in children.
What are the symptoms?
FND can mimic many neurological diseases. Common symptoms include weakness of an arm or leg, tremors or jerky movements, difficulty walking, non-epileptic attacks resembling seizures, speech difficulties, numbness, vision-related complaints, fatigue and cognitive 'brain fog'.
Symptoms may fluctuate dramatically. Some patients may appear severely disabled one day and better the next, which sometimes leads others to wrongly assume the illness is not genuine.
Why does FND happen?
The exact mechanisms are complex and still being researched. Current evidence suggests FND involves abnormal functioning of brain networks involved in movement, attention, emotion, and body awareness. Brain imaging studies have shown altered activity patterns in certain brain regions in people with FND.
Psychological stress, trauma, anxiety, depression, chronic pain, sleep deprivation, or major life events may act as triggers in some patients, but not always. Importantly, not every patient with FND has obvious psychological problems. This is why modern medicine no longer views FND simply as 'hysteria' or 'imagined illness'. It is a real disorder at the intersection of neurology and psychiatry.
Why is diagnosis often delayed?
One major reason is that routine investigations are usually normal. Patients often undergo multiple MRIs, blood tests, EEGs and nerve conduction studies. When reports come back normal, families may feel frustrated and doctors unfamiliar with FND may mistakenly dismiss symptoms as attention-seeking or purely psychological. Unfortunately, such responses can worsen suffering and delay recovery.
Today, neurologists diagnose FND not merely because tests are normal, but because they identify specific positive clinical signs characteristic of FND during examination.
Who treats FND: neurologists or psychiatrists?
Ideally, both. Neurologists usually make a diagnosis and exclude major neurological diseases. Psychiatrists, psychologists, physiotherapists, and rehabilitation specialists may all contribute to treatment. FND should not be dumped entirely onto psychiatry after normal tests. It is best managed through a collaborative, multidisciplinary approach.
Can FND be treated?
Yes, and many patients improve substantially.
Treatment may include a clear explanation of the diagnosis, physiotherapy focused on retraining movement, psychological therapies such as cognitive behavioral therapy (CBT), treatment of anxiety, depression, sleep problems, or chronic pain, and stress management and rehabilitation.
An important step is helping the patient understand that the symptoms are real, common, and potentially reversible.
What is the long-term outlook?
The prognosis varies from patient to patient. Some patients recover completely, especially when diagnosed early and treated appropriately. Others may continue to have fluctuating symptoms over time.
Delayed diagnosis, repeated invalidation (“nothing is wrong with you”), and unnecessary investigations may worsen disability.
The good news is that awareness about FND is increasing worldwide. More neurologists now recognize that these patients need empathy, scientific treatment, and rehabilitation, not dismissal.
For patients like Sneha, receiving the correct diagnosis was not the end of the journey. It was the beginning of recovery.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.