What FND is — and what it is not
FND is a recognised neurological condition in which the nervous system does not work normally despite a normal structural scan. It can affect movement, sensation, vision, speech, swallowing, gait or awareness. The symptoms are real and involuntary; they are not deliberately produced or imagined.
The diagnosis is made from positive clinical signs and a consistent history, not simply by excluding other diseases. Many patients are told 'nothing is wrong' after a normal MRI, which is unhelpful. A specialist can explain what is happening, why it is treatable and how to begin recovery.
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Common presentations
Functional attacks can resemble epilepsy and are often called non-epileptic attacks. Video EEG is sometimes needed to distinguish them from epileptic seizures, especially when both occur in the same person. Functional movement can look like tremor, dystonia, jerky movements or difficulty walking.
Functional weakness may affect one side or both legs, and functional sensory loss can cause numbness or tingling. Speech may become slurred or whispering. Symptoms often fluctuate, are distractible and may worsen with attention or stress, but these patterns are clues rather than proof.
- Attacks with altered awareness or shaking
- Weakness, heaviness or paralysis of an arm or leg
- Tremor, jerking, dystonia or abnormal gait
- Numbness, tingling or sensory loss
- Speech, vision or swallowing symptoms
Assessment and treatment
Assessment includes the event history, witness or video recordings, a full neurological examination, and review of imaging, EEG and blood tests. Dr. Yadav looks for positive signs of FND, rules out competing diagnoses where necessary, and explains the diagnosis in a way that makes sense to the patient and family.
Treatment is rehabilitation-focused. Physiotherapy, occupational therapy and speech therapy are adapted for FND. Cognitive behavioural therapy, trauma-informed therapy and treatment of anxiety, depression or PTSD can help. Safety planning and regular follow-up matter. Recovery is possible, especially with early diagnosis, a clear explanation and coordinated care; relapses are also common and should be managed without blame.
| Concern | Helpful approach |
|---|---|
| Is it 'all in my head'? | No — FND is a real brain-network disorder, not fabrication |
| Do I need more scans? | Usually not; repeated imaging can delay treatment |
| Can it improve? | Yes, with explanation, rehabilitation and psychological support |
| Who else is involved? | Physiotherapy, speech therapy, psychology or psychiatry as needed |
Access and booking
Appointments are at Kathmandu Neurology Clinic & Cognitive Center, 117 Lal Durbar Marg, Kathmandu, opposite Yak & Yeti Hotel. Call +977-9747736624 or use /book-appointment. Bring prior reports, imaging, seizure or symptom records and a medication list. Neurophysiology tests are arranged at an affiliated laboratory or hospital when indicated; the consultation confirms whether the test is appropriate and explains the result.