Functional Neurological Disorder medical negligence claims

What is Functional Neurological Disorder?

Functional Neurological Disorder (‘FND’) has only relatively recently been recognised as a condition in its own right. Historically, patients with neurological symptoms that could not be explained by conventional diagnostic methods were often left without a diagnosis. This phenomenon is now classified as FND.

Compared to some other neurological conditions, such as Parkinson’s disease, where damage to the brain or nerves can be visualised, in a patient with FND the structure of the brain appears healthy.

Despite how things look, however, the way that the brain functions is impaired and can cause real and significant symptoms and trauma.

The team at Thomson Snell & Passmore has acted on a wide variety of clinical negligence and personal injury cases involving Functional Neurological Disorder (FND), and succeeded in achieving compensation for patients affected by this complex neurological condition.

What causes FND and what are the symptoms?

It is not fully understood what causes FND and it does not have a single, isolated cause.

It can be the result of psychological stress or trauma, often accompanied by physical injury, such as a road traffic accident, surgical procedure or a fall.

Where FND is the result of a reaction to physical or psychological trauma, symptoms may not develop until several weeks or months after the event. Some people may also be naturally more vulnerable to FND due to predisposing factors, including chronic physical and/ or mental illness, long-term pain, or a history of psychological stress.

Symptoms may impact a person’s:

• Mobility – such as dizziness, a lack of coordination, motor or limb weakness or involuntary jerking movements;
• Senses – such as tingling sensations, numbness or impacts to vision or hearing; and
• Cognitive ability – such as memory loss or difficulties concentrating.

Since it primarily affects the nervous system, FND can also mimic a variety of other neurological conditions. It is this, combined with the intertwining of physical and neurological symptoms, that makes FND a complex condition to treat and diagnose.

How is FND diagnosed?

In the past, FND was only diagnosed after everything else had been ruled out. It was known as a ‘diagnosis of exclusion’.

The way FND is identified has now shifted, and neurologists today should look for positive clinical signs during a physical examination.

The clinical signs will depend on the patient’s presenting complaint and symptoms, and will differ in every case.

However, one of the most well-known examples is called ‘Hoover’s Sign’. It is an involuntary reflex test used to differentiate between leg weakness that has been caused by physical damage (such as muscle weakness) versus neurological damage.

Demonstrating Hoover’s Sign and other similar tests allow clinicians to illustrate to patients that their brain can still operate their limb or other affected parts of their body normally, which is often a crucial first step in achieving rehabilitation.

Importantly, this doesn’t mean the weakness is fake; it merely proves that the physical pathways to the muscles are fully intact, and that the brain’s voluntary control mechanism is malfunctioning.

How common is FND?

Despite previously having been classified a ‘diagnosis of exclusion’, FND is now an increasingly common condition.

The National Institute for Health and Care Excellence in the UK (‘NICE’) estimated in 2021 that up to 100,000 people in the UK live with FND, with roughly 8,000 new cases being diagnosed each year.
NICE also estimates that FND is more common in women than men, with new diagnoses typically affecting those aged 35 to 50.

What is the treatment for FND?

There is no one definite treatment for FND and this will depend on each specific case. Often, treatment will involve a combination of physical rehabilitation and cognitive behavioural therapy.

Managing any physical or mental triggers can help to relieve pressure on the nervous system and in turn allow the brain to take back control, with the ultimate aim of re-training the brain to operate the affected parts of the body.

Obtaining a diagnosis is a critical first step and can often be the turning point in managing or treating symptoms associated with FND.

How can I make a FND claim?

If you have been diagnosed with FND following an injury or accident, contact our specialist team for a free initial consultation to find out if we can investigate your case with the financial security of a “no-win, no-fee” agreement.

Our breadth of experience and position as one of the longest established clinical negligence & personal injury teams in the country means it is likely that we have already recovered compensation in a case similar to yours.