Download FND app Android Aapp IoS App
FND Links Feedback Donate Language
  • English
Home / Causes / Misdiagnosis / Comorbidity

Misdiagnosis / Comorbidity

Is the diagnosis wrong?

Patients with functional/dissociative symptoms are often concerned that their diagnosis may be wrong. Especially since there is no ‘scan’ or blood test that can make the diagnosis.

There are many neurological problems. The commonest ones are

• Stroke
• Epilepsy
• Migraine / Headache
• Functional / Dissociative Symptoms
• Multiple Sclerosis
• Brain Tumour
• Parkinsons Disease
• Myasthenia Gravis
• Motor Neuron Disease (also called Amyotrophic Lateral Sclerosis)
• Peripheral Neuropathy
• Nerve Root or Spinal Cord entrapment
• B12 deficiency and Thyroid disorders
• Many hundreds of others…..

On the other hand there are also only a limited number of neurological symptoms. The commonest ones are:

• Headache
• Weakness
• Sensory Symptoms
• Blackouts
• Memory / Cognitive symptoms
• Speech / Swallowing Symptoms
• Dizziness
• Visual Symptoms – reduced vision, double vision
• Neck, Back and Limb pain
• Tremors, jerks, spasms and contractures
• Bladder symptoms

In fact there are such a limited number of neurological symptoms you can see that its quite understandable for someone with more than one neurological symptom to start to wonder if they have one of the common (or uncommon) neurological diseases.

This website does not attempt to explain how a neurologist diagnoses all of these diseases. But this list emphasises that neurologists are very familiar with the conditions that you, your family or friends may have been concerned about as well as all the symptoms that you have.

You may be surprised to see FND so high up the list because few people have heard of them. In fact around 15% of all patients seen in UK neurology clinics as new patient have symptoms that are diagnosed as functional or dissociative. Around 5% of all new outpatients have symptoms of weakness, blackouts or numbness that are related to FND

If your neurologist has decided that you have FND it should be for a good reason. There should be positive signs that the problems is functional, it should not just be because the scan is normal or the tests are normal. See positive signs of functional weakness, functional sensory disturbance and dissociative seizures.

In the same way that neurologists diagnose Parkinson’s disease, Migraine and Epilepsy at the bedside with a detailed history and examination (and without any tests), so too can FND be accurately diagnosed.

Can you have FND and another neurological condition?

Yes, this happens quite a lot. Heres a video…

Things can become tricky when a patient has an underlying neurological disease (like multiple sclerosis) and they also have clear evidence of functional symptoms (like FND related limb weakness). In some people, having a neurological disease can actually trigger the development of functional symptoms and something that a neurologist should always think about. This is often why investigations are performed even when clinically the diagnosis seems clear. Some people can have two diagnoses – one of a neurological disease and another of superimposed functional symptoms. For example, about 10-15% of people with dissociative seizures also have epilepsy (but 90% still do not).

You can read an article I wrote with colleagues about pitfalls in misdiagnosis of functional symptoms and neurological disease below.

Click the image for an article written for neurologists about the pitfalls of diagnosis of FND and related conditions

Reassuringly however, studies that have looked at how often neurologists get the diagnosis wrong have tended to agree (at least in the last 30 years) that the proportion of patients in whom the diagnosis turns out to be incorrect later on is about 5%. The graph below is based on 27 studies and nearly 1500 patients followed up for an average of 5 years. It shows how the diagnosis has become more accurate over the years.

This study collected together all the previous studies looking at how often doctors got the diagnosis of functional neurological symptoms wrong. Rates of misdiagnosis have been around 5% since 1970. This is the error rate for all neurological conditions. (Stone et al BMJ. 2005; 331: 989;

A misdiagnosis rate of 5% may seem a lot but perhaps surprisingly its less than the numbers of patients misdiagnosed with epilepsy, multiple sclerosis and similar to the proportion wrongly told they have motor neurone disease.

The evidence suggests that misdiagnosis of a neurological disease when the problem is actually functional / dissociative symptoms is just as common as the other way round.

In conclusion…

Any doctor, usually a neurologist, that makes the diagnosis of FND should be very familiar both with the possible neurological diagnoses that those symptoms could represent and also with the positive clinical features of functional symptoms. Even then, they will sometimes get it wrong, but no more often than for other neurological diagnoses.

home window repair chino ca mobile home replacement window broken window repair home window well replacement replacement show how to measure for a replacement window estimate for replacement windows replacement windows nashua comparing vinyl replacement windows home window repair east rockaway ny window replacement cleveland tn pella casement window operator replacement window buck installation origin installation window black blaine window repair jalousie window slats replacement how to repair a rear window defroster window installation vinyl siding double glazing repairs wirral window repair dublin ohio window replacement columbia city replacement windows oswego ny

what are the health benefits of cbd oil zylis pur7 cbd oil cbd oil is cbd oil teenagers autism can you fly with hemp oil cbd oil fcharlottes web youtube green relief cbd oil using dmso with cbd oil cbd oil weightlifting what is cbd stand for normal cbd oil city of sarasota ban on cbd oil online discount codes for fab cbd oil vitamin shoppe cbd oil living freeze what does cbd oil contain for headaches which is the best cbd oil brand google cbd oil adwords jay watkins cbd oil cbd oil versus cannabis oil where to buy hemp cbd oil cbd oil fda schedule tell me the benefits of cbd oil and insomnia

cost of generic cialis natural ed pills sexual health products wellbutrin to increase libido penis enlargement best octane testosterone booster erectile dysfunction otc treatment most effective penis enlargement sex wumen male enhancement testosterone pills viapro herbal male enhancement testosterone pills sperm count male enhancement pills manufacturers china chinese main land sex enhancement pills ron jeramey penis pills mens sexual health vitamins over the counter testosterone pills reviews testosterone pills steroids for sale medication for testosterone pills willy male enhancement pills can you take horse testosterone pills how to make a girl to have sex with you

amanda seyfried weight loss rapid diet pills that work fda approved over the counter weight loss pills over the counter diet pills similar to phentermine fruits on keto diet list dash diet pdf best safe diet pills to lose weight lose weight fast in one week lazy keto diet menu how many carbs can i have on keto diet weight loss alli pills bee pollen diet pills will my doctor prescribe weight loss pills keto diet chart diet pills for obese 100 natural diet pills xiushentang diet pills keto diet fat protein carbs fastin xr diet pills for sale non stimulant diet pills best gluten free diet pills different weight loss pills