What Are Functional Neurological Symptoms? Understanding FND and How to Manage It

Symptoms That Are Real—And Reversible

 You’re experiencing strange, disruptive symptoms—sudden weakness, tremors, seizures—but all the tests come back normal. It feels scary, confusing, and like no one believes you.

 These are known as Functional Neurological Symptoms. They are very real, and with the right support, they are treatable. At Exercise Matters, we help clients understand and manage these symptoms using evidence-based treatment and functional rehabilitation.

What Are Functional Neurological Symptoms?

Functional Neurological Disorder (FND) is a condition where the brain has trouble sending and processing signals correctly. Symptoms aren’t caused by structural damage but by a disruption in communication between the brain and body.

Here are the most common symptoms—and what helps.

1. Limb Weakness or Paralysis

Often affecting one side of the body, this can appear suddenly and mimic a stroke.

Evidence-Based Treatment:

• Graded strength training to build motor confidence

• Distraction-focused movement tasks to bypass overthinking

• Gait retraining and functional task repetition

Supported by Nielsen et al. (2015), showing functional gains through movement re-patterning.

2. Tremors or Jerky Movements

Involuntary shaking or movements that vary in rhythm and intensity.

Evidence-Based Treatment:

• External focus of attention (e.g., catching a ball while moving)

• Rhythmic exercises like dancing, drumming, or metronome stepping

• Graded exposure to triggering tasks

3. Gait Abnormalities (Walking Issues)

Some clients lose the ability to walk normally or experience sudden leg collapse.

Evidence-Based Treatment:

• Gait retraining with visual cues (e.g. stepping over lines)

• Dual-task walking to shift attention away from body monitoring

• Confidence-building drills and safe exposure

Studies show that combining physiotherapy and Exercise Physiology improves walking outcomes in FND.

4. Dissociative (Non-Epileptic) Seizures

These look like epileptic seizures but are not caused by electrical brain activity.

Evidence-Based Treatment:

• Psychological therapy (especially CBT or trauma-informed care)

• Breathing and grounding techniques

• Gentle movement reintroduction post-event

Stone et al. (2010) recommend education plus a combined psychological and physical approach.

5. Speech or Voice Changes

Difficulty speaking, voice loss, or stuttering without a structural cause.

Evidence-Based Treatment:

• Speech therapy targeting breath control and voice projection

• Relaxation techniques for reducing tension in the throat

• Group voice or singing therapy (as tolerated)

6. Functional Sensory Loss

Numbness, tingling, or vision issues with no neurological explanation.

Evidence-Based Treatment:

• Sensory retraining via touch, vibration, or texture exposure

• Mirror therapy and guided visualisation

• Movement tasks using the affected area to normalise sensory feedback

7. Fatigue and Functional Cognitive Fog

Feeling constantly drained or mentally foggy even after rest.

Evidence-Based Treatment:

• Energy conservation and pacing education

• Aerobic exercise in small, regular doses

• Cognitive training with physical task layering

How We Help at Exercise Matters

We provide:

• Movement retraining in a calm, supportive environment

• Collaboration with psychologists, neurologists, and other providers

• Programs adapted daily to symptom patterns and progress

• Support for NDIS and Medicare-funded clients

Take the Next Step

Understanding your symptoms is the first step to managing them. Let us support your recovery with practical strategies backed by science and delivered with compassion.

📞 Call (07) 5448 3532 🌐 www.exercisematters.healthcare

References:

• Nielsen G et al. (2015). Physical treatment of functional motor disorders. J Neurol Neurosurg Psychiatry.

• Stone J et al. (2010). Functional neurological symptoms: assessment and treatment. BMJ.

• Carson A et al. (2020). Multidisciplinary treatment of FND. Neurology.