Functional symptoms are a common illness that can affect people in a variety of ways including abdominal discomfort, pain, disturbed sleep and fatigue. Other names used to describe such illness include psychosomatic illness and conversion illness.
Functional neurological symptoms is the term used to describe the illness people experience when they have functional symptoms that affect the nervous system. Common functional symptoms of the nervous system include sensory symptoms, loss of power, difficulties walking, tremor, difficulties with speech and memory.
In contrast to illnesses such as Multiple Sclerosis and Motor Neuron Disease that cause structural illness or damage of the nervous system (brain, spinal cord, nerves and muscles), in functional symptoms and functional neurological disorder, the structure and integrity of the nervous system remain intact. However, people with functional neurological disorder may experience difficulty using their nervous system effectively. This may often happen as a response or reflection of a wide range of psychological factors and life circumstances.
The diagnosis of functional neurological symptoms and disorder is made following clinical assessment by a doctor, who will detect positive features of functional neurological symptoms and if needed, rule out other neurological illness. Most patients with mild functional neurological disorder will benefit from a clear explanation of the diagnosis and self-help strategies to address psychological factors that may have contributed to the illness. The website www.neurosymptoms.org supported by the Scottish Government is a helpful resource for patients and families experiencing and living with functional neurological disorder.
In patients with significant or long-standing functional neurological disorder, review by an appropriate mental health team, such as a local community mental health team, may help identify, manage and improve mental health issues that may have contributed to their functional neurological disorder.
In some people, review and advice by physiotherapy may be helpful. Typical rehabilitation services are offered in the community but at times, physiotherapy may also be offered in clinics in hospital settings. In some circumstances, review by a neuropsychologist may guide further input by community and other mental health teams.
In Greater Glasgow and Clyde, all consultant neurologists and specialist trainees in neurology assess patients with functional neurological symptoms.