ALPIMS • UNDERSTANDING CONNECTIONS
Migraine
& FND
Migraine and functional neurological disorder can occur together. Understanding both can help guide suitable care.
Both conditions are real.
Care should address your symptoms, needs and capacity.
One section at a time.
Read what helps. Leave the rest for later.
What is FND? Real, involuntary neurological symptoms
Functional neurological disorder (FND) affects how the nervous system functions. Symptoms may include weakness, movement difficulties, altered sensation or functional seizures.
The symptoms are real and not deliberately produced. A psychological stressor is not required for diagnosis.
How are migraine and FND connected? They can occur together
Migraine is reported in people with FND, including functional seizures. Research on the overlap is still limited and estimates vary.
Migraine attacks may trigger or worsen functional symptoms in some people. This does not mean migraine always causes FND.
Someone may need treatment for both. Neither diagnosis cancels the other.
Could symptoms be difficult to distinguish? Timing and examination help
Migraine aura can involve visual changes, tingling or speech symptoms. Some migraine types can include weakness.
FND can also affect movement, sensation or speech. These similarities do not make the conditions interchangeable.
New or sudden neurological symptoms need urgent assessment. Do not assume they are your usual migraine or FND.
How is FND diagnosed? Positive clinical features matter
A specialist should diagnose FND from recognisable clinical features, such as specific examination signs or features of an episode.
A normal scan alone does not diagnose FND. Anxiety, trauma or unexplained symptoms alone do not diagnose it either.
Tests may be needed for other conditions. Functional seizures and epilepsy can coexist, and the team may use video-EEG when appropriate.
What can treatment offer? A coordinated plan for both conditions
Migraine care may include acute and preventive treatment. Limited observational evidence suggests treating migraine may also help functional episodes in some people, but this is not a guaranteed outcome.
FND care depends on symptoms. It may include specialist physiotherapy, occupational therapy, speech therapy or psychological therapy.
Psychological support can be useful without assuming symptoms are imagined. Ask for clear explanations and shared goals.
Adapt rehabilitation to other conditions and capacity. If you have post-exertional malaise, avoid pushing through or fixed increases in exercise.
Professional care ↗What may help day to day? Simple plans and less load
- Use your agreed migraine and FND care plans.
- Reduce uncomfortable light, noise and non-essential demands.
- Allow breaks and practical support.
- Note whether symptoms happen before, during or after migraine.
A short note is enough. You do not need to monitor every symptom.
For diagnosed functional seizures, ask for a written response plan. New, different or uncertain episodes need medical assessment.
When should I seek urgent help? Do not let a past diagnosis delay care
Call 000 in Australia for new sudden weakness, facial droop, difficulty speaking, sudden vision loss or a sudden extremely severe headache.
Call 000 for a first seizure-like episode, serious injury, breathing difficulty or failure to recover as expected. For familiar diagnosed episodes, follow the agreed emergency plan.
Seek urgent medical assessment for headache with fever and a stiff neck or a new severe headache after injury.
ALPIMS notes & references Support the whole picture
This overlap includes Pain / Bodily Sensitivity and neurological or sensory needs. Sleep, fatigue, autonomic symptoms and emotional wellbeing may also need attention.
FND does not automatically imply a mental health condition or neurodevelopmental diagnosis.