Navigating the Confusion: Functional Neurological Disorder Diagnosis
Hello to all the medical professionals and fellow patients out there! I'm reaching out for some guidance regarding a perplexing situation I'm currently facing. At 27 years old and feeling disoriented, I hope some of you might share your insights or experiences related to my condition. Not long ago, I was informed that I may have Functional Neurological Disorder (FND). While I certainly recognize that FND is a valid and serious condition, I find myself feeling quite ashamed at the thought that my symptoms might simply be functional in nature. While I can appreciate that FND could potentially explain my symptoms, I'm struggling to reconcile this diagnosis with the clear abnormalities evidenced in my imaging and medical history. I’m open to the possibility of this diagnosis, but I need reassurance that no significant structural issues are being overlooked. Here’s an overview of my situation: - I have a diagnosis of antiphospholipid syndrome (APS), which I manage with warfarin, occasional injections of lovenox, and regular check-ups at an anticoagulation clinic. - Imaging has revealed unilateral stenosis on the right side of my brain that looks similar to moyamoya syndrome, although it doesn't fit the classic profile (the narrowing starts at my neck and affects only one side). This finding was first noted back in 2019 when I had my very first MRI due to a seizure episode. - I also have a documented history of chronic infarcts in both hemispheres of my brain, as shown on MRI scans. These were determined to be unrelated to the stenosis based on their locations. The left-side infarcts were diagnosed in January 2023, despite not being present in my prior MRI from 2021. - Additionally, I suffered a subdural hematoma and a severe concussion in January due to a head injury, which was confirmed by imaging studies. After a lengthy evaluation in the ER, I was discharged after 7 hours when follow-up CT scans indicated that the bleed had stabilized. - Since 2019, I have experienced several grand mal seizures, which I have little memory of. They were proceeded by an unusual rubbery odor, and witnesses validated the seizure events. I’ve been diagnosed with epilepsy and currently take lamotrigine at a dosage of 150 mg twice daily. However, I feel that the infrequency and mild nature of my seizures do not warrant the epilepsy classification. - A recent transcranial Doppler ultrasound indicated significantly elevated pressure on the right side of my brain (measured between 190 and 200 cm/s). - A few weeks ago, I had an alarming episode involving sudden vision loss in my right eye, facial drooping, and slurred speech, which resulted in a three-day hospital stay. The MRI did not show any acute infarcts, leading to the conclusion that I likely experienced a transient ischemic attack (TIA). - Following this episode, I’ve been dealing with ongoing right-sided weakness and difficulties with facial movements. Clinicians have suggested that these persistent symptoms do not align with TIA criteria and seem more consistent with a stroke; however, imaging taken during my hospitalization did not show acute damage. As a result, I have been directed towards the idea that this is likely a functional disorder despite the array of objective findings supporting my condition. Although I do not aim to undermine FND, I can’t shake the feeling of embarrassment, as if I have wasted resources and time, questioning whether I might have been exaggerating or imagining my symptoms. Yet, I review the scans and test results, and it's clear that there are indeed abnormalities present. I have a few pressing questions for anyone who can provide clarity: - Has anyone experienced a similar transition in diagnosis from clear neurological anomalies to being classified with FND? - What methods do clinicians typically employ to differentiate between functional and organic symptoms in complex cases like mine? - Is there a potential for FND to occur alongside structural brain injuries, and how do medical professionals manage that distinction in practice? - Could ongoing deficits resulting from a TIA or a stroke be misidentified as FND when no acute lesions can be detected? - Should I seek a second opinion or consult a neurovascular specialist, or is it reasonable to embrace the FND diagnosis as outlined by my case? Any insights on how a functional diagnosis could fit into my circumstances or whether I might be jumping to conclusions would be enormously appreciated.
Answers (1)
8/1/2025, 4:20:58 PM
OpenHealth AI
It’s understandable to feel overwhelmed and confused by your diagnosis and complex medical history. Your concerns regarding Functional Neurological Disorder (FND) and its relationship with your established neurological conditions are valid and warrant careful consideration. Here’s a structured approach to address your situation:
Main Points
- FND can coexist with organic conditions; it doesn't invalidate your symptoms.
- Differentiating between FND and organic disorders is complex and requires thorough evaluation.
- Seeking a second opinion could provide clarity and reassurance.
Explanation
Functional Neurological Disorder (FND) involves neurological symptoms that cannot be explained by traditional neurological diseases, even when physical changes exist. This does not mean your symptoms are "imagined" or exaggerated; rather, they may result from how your brain functions rather than structural abnormalities.
Given your history of antiphospholipid syndrome, chronic infarcts, and transient ischemic attacks (TIAs), it’s crucial to acknowledge that while you may exhibit signs of FND, the underlying structural issues can still influence your condition. The relationship between structural brain injuries and FND is complex; ongoing deficits can sometimes be mistakenly attributed to a functional cause, especially if imaging is normal during acute episodes.
Next Steps
-
Second Opinion: Consider seeking a second opinion from a neurovascular specialist or a neurologist familiar with FND. This can provide further insights into managing both your structural issues and potential FND.
-
Specialist Evaluation: Ask specifically about:
- How your symptoms can fit into both the organic and functional categories.
- Methods used to differentiate between FND and ongoing deficits from your previous neurological events.
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Symptom Diary: Maintain a diary of your symptoms, noting triggers, durations, and severity. This can help in future consultations and give healthcare providers a clearer picture of your experience.
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Support Resources: Seek support from groups focused on FND or chronic neurological conditions, where you can connect with others sharing similar experiences.
You are not alone in navigating these complexities, and taking proactive steps towards your health concerns is commendable. Make sure to prioritize your well-being and advocate for the comprehensive care you deserve. If you have further questions or need clarification, please reach out.
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