Expert Care for Neuralgias and Tremors

Banner Health’s neurologists are experts in treating patients suffering from functional neurological disorders. We take a compassionate, collaborative and highly personalized approach to your care. Our experienced team is dedicated to getting you answers and solutions quickly, so you can start feeling better. 

What Is a Functional Neurological Disorder (FND)?

Although relatively common, most people haven’t heard of functional neurological disorders (FNDs). FNDs are debilitating medical conditions that affect the brain and nervous system. FNDs are very real diseases, with symptoms that cause significant distress and disability if left untreated.

FNDs are diagnosed when a patient has neurological and psychiatric symptoms that can’t be explained by a known neurological disorder or medical disease. Patients with an FND experience a wide variety of neurological symptoms, including limb weakness, seizures, numbness and vision problems.

FNDs can be hard to understand. Symptoms differ patient-to-patient and can mimic other medical and mental health illnesses. FNDs can be attributed to biological, environmental and psychological vulnerabilities; however, their exact causes are unknown.

Banner Health’s multidisciplinary team is experienced in evaluating and caring for patients with FNDs and their families. With early diagnosis and treatment, successful recovery is possible.

Types of Functional Neurological Disorders

  • Glossopharyngeal neuralgia: A disorder causing severe pain in the tongue, throat, larynx, ears and tonsils.
  • Trigeminal neuralgia: A painful condition affecting the trigeminal nerve, causing burning or shocking facial pain to the lips, eyes, nose, scalp, forehead and jaw. Each episode can last a few seconds to a few minutes, and can happen repeatedly for up to two hours.
  • Hemifacial spasm: A disorder causing muscles on one side of your face to spasm. It usually starts with twitching of one eyelid and then spreads to the lower face. Eventually, the eye is forced closed and the mouth may be pulled to one side.  
  • Essential tremor: A nervous system disorder that causes involuntary shaking, often in your hands and affecting small tasks like tying your shoe. It differs from Parkinson’s disease as essential tremor occurs without other neurological symptoms.
  • Parkinsonian: Most patients with Parkinson’s disease experience tremors. Parkinson’s tremors are rhythmic (slow, continuous), tend to start on one side of your body and happen when your muscles are still. 

What Causes Functional Neurological Disorders?

The exact cause of an FND is unknown. They involve a problem with the part of your brain controlling your muscles and senses. Triggers for symptoms can't always be identified, but sometimes it occurs after a stressful event, emotional distress or physical trauma.

FND Risk Factors 

FNDs can affect anyone, at any time. However, FNDs are uncommon in children under 10 and affects more women than men. Research points to predisposing factors that may make some patients more prone to an FND, including having a:

  • Neurological disorder, such as epilepsy or migraines
  • Mental health condition
  • Close relative with FND

FND Prevention

There is no known way to prevent a functional neurological disorder. 

What Are Signs and Symptoms of Functional Neurological Disorders?

It can be difficult to correctly diagnose an FND. Patients with an FND can have a wide range and combination of physical, sensory, emotional and cognitive symptoms. Symptoms can vary day-to-day and can happen continuously or sporadically. Some patients also may experience long periods of being symptom-free.

The most common symptoms of FNDs include:

  • Difficulty swallowing 
  • Difficulty walking
  • Hearing issues or deafness
  • Loss of balance
  • Loss of consciousness/fainting
  • Numbness 
  • Periods of unresponsiveness
  • Seizures or shaking
  • Speech problems, such as a soft voice or slurred speech
  • Tremors 
  • Vision problems, such as double vision or blindness
  • Weakness or paralysis

FNDs have symptoms similar to other neurological disorders and it’s common for patients to have an FND and other conditions such as stroke, depression and fibromyalgia. 

If you are experiencing any of these symptoms, talk to your doctor right away. Early diagnosis and treatment are important to effective treatment and recovery. 

How Is a Functional Neurological Disorder Diagnosed?

Banner Health’s neuroscience team are experts in diagnosing and treating patients with FNDs. We use a multidisciplinary approach that includes medical and mental health professionals to accurately diagnose FNDs. 

An FND is primarily diagnosed based on symptoms. Although the patient is experiencing symptoms, brain imaging tests (EEG, MRI, CT scan) won’t show any abnormalities or changes. For these reasons, it’s important to seek a diagnosis from a neurologist experienced in FNDs.

FND Testing 

An FND requires an evaluation and diagnoses from a neurologist, including: 

  • Review of health history and symptoms analysis
  • Physical exam
  • Neurological exam
  • Psychiatric exam
  • DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) evaluation looking to see if:
    • Symptoms are affecting movement or senses
    • Symptoms can't be explained by another neurological, medical or mental health condition 
    • Symptoms are causing significant distress or disruption to daily activities

FND Prognosis 

If left untreated, an FND can have a devastating impact on a patient’s quality of life. The severity of symptoms can be debilitating and affect a patient’s ability to work, socialize and care for themselves. However, with proper diagnosis and treatment, Banner Health doctors are able to help patients manage and improve their symptoms and live their lives to the fullest. 

How is Functional Neurological Disorder Treated?

Treatment starts with your doctor giving you a clear explanation of your diagnosis. Understanding FNDs are relatively common conditions and that symptoms can improve over time helps to reduce anxiety. 

Banner Health’s expert team builds each patient with an FND an individualized treatment plan, which may include:

  • Psychoeducation
  • Psychotherapy
  • Cognitive behavioral therapy (CBT)
  • Behavioral interventions
  • Hypnosis
  • Medication
  • Transcranial magnetic stimulation (TMS)
  • Physical therapy
  • Virtual reality 

Banner Health doctors take a multidisciplinary approach to your care, which may include a neurologist, psychiatrist, speech, physical and occupational therapists and others. It’s also important you have regular follow-up with your medical team to monitor your recovery and make changes to your treatment plan as needed.

FND Support

Connecting with others with an FND can help with recovery. Learn more about FND support groups at Banner Health.