ALPIMS · FND
When the nervous system gets stuck.
Understand Functional Neurological Disorder (FND), recognise neurological symptoms and find practical ways to support movement, communication and everyday life.
Explore practical tools ↓
This page offers general information and practical options. It does not diagnose FND or replace individual medical care.
What is FND? A disorder of nervous-system functioning.
Functional Neurological Disorder (FND) is a neurological condition in which the nervous system is not functioning normally, producing genuine neurological symptoms.
FND can affect movement, sensation, speech, vision, swallowing, attention, awareness and episodes that may resemble seizures.
The word functional refers to how the nervous system is working rather than meaning that the symptoms are imaginary or deliberately produced.
FND is not simply a diagnosis made because a scan is normal. Clinicians can identify positive features during a neurological examination that support the diagnosis.
FND can occur alongside other neurological or medical conditions. Having FND does not mean that every future symptom is caused by FND.
Why can symptoms change? Neurological symptoms can vary with context.
FND symptoms can fluctuate. Movement, attention, fatigue, pain, sensory input, stress, illness and the environment may influence symptoms in some people.
This variability does not mean that symptoms are voluntary or that the person can simply switch them off.
A person may sometimes be able to perform a movement automatically but struggle when consciously trying to perform the same movement. Such patterns can be useful clinical information.
Symptoms may improve in one situation and worsen in another without this being deliberate.
Quick tool: “When is it easier? / when is it harder? / what changes around it?”
FND is not “all in your head” Mind and nervous system interact, but symptoms are real.
FND has sometimes been misunderstood as meaning that symptoms are imaginary or caused simply by psychological distress.
That is not an appropriate way to explain FND.
Psychological factors, trauma, anxiety or depression can be relevant for some people, but they are not required for FND and should not be assumed to be the cause.
Physical symptoms and emotional experiences can influence one another without making the physical symptoms unreal.
Good care starts by taking the symptoms seriously and explaining why the diagnosis fits.
Tools that may help
Tap a coloured button ↗. These are practical options, not tests or requirements.
Movement & retraining Work with automatic movement where possible.
Physiotherapy for FND may focus on retraining movement, reducing unhelpful movement patterns and building confidence in automatic movement.
The right approach depends on the person’s symptoms, physical capacity and other health conditions.
Quick tool: “What movement is easier automatically? / what support helps?”
Make it fit: Rehabilitation should be individualised. If you also have pain, fatigue, ME/CFS, hypermobility or another condition, the plan may need to account for those limits. If you experience PEM, avoid fixed activity increases and discuss energy management with your team.
Understanding functional movement symptoms — Coming soon Planning FND physiotherapy — Coming soonFunctional seizures Episodes can look like epilepsy but have a different mechanism.
Some people with FND experience episodes called functional seizures or functional/dissociative seizures.
These episodes can involve shaking, altered awareness, unresponsiveness or other changes that may resemble epileptic seizures.
Functional seizures are real and involuntary. They are not deliberately produced.
Epilepsy and functional seizures can also coexist, so a new or changing episode should be medically assessed rather than assumed to be FND.
Quick tool: Follow an individual safety plan agreed with your clinician. Record what happens before, during and after an episode when safe, with the person’s consent. Seek urgent help for a first episode, injury, breathing problems or an episode outside the agreed plan.
My episode record — Coming soon My functional seizure safety plan — Coming soonSensation & pain Numbness, altered sensation and pain can be neurological symptoms.
FND can involve altered sensation, including numbness, tingling, changes in touch or unusual sensory experiences.
Pain can also occur and may be severe or disabling.
Symptoms may fluctuate and can sometimes affect different parts of the body at different times.
Quick tool: “Where is it? / what does it feel like? / what changes it?”
Make it fit: New neurological symptoms should not automatically be attributed to FND. Seek assessment when symptoms are new, severe or different from your established pattern.
Sensation changes: what to record — Coming soon Pain alongside FND — Coming soonSpeech & communication Communication symptoms deserve practical support.
FND can affect speech, voice, articulation, fluency and other aspects of communication.
Speech may become difficult, slow, strained or inconsistent. Communication difficulties are not necessarily a sign that someone does not understand what is being said.
Speech and language therapy may be helpful for appropriate symptoms.
Quick tool: “I understand / I need time / please give me another way to answer.”
Make it fit: Allow typing, writing, gestures or communication aids when needed. Do not interpret difficulty speaking as lack of understanding.
My communication needs card — Coming soon Functional speech & swallowing support — Coming soonBrain fog & attention Reduce cognitive load when symptoms fluctuate.
Some people with FND experience difficulties with attention, memory, concentration or a sense of being detached or disconnected.
Cognitive symptoms can become more noticeable when someone is fatigued, overwhelmed or trying to manage several demands at once.
Written information, one question at a time and additional processing time can make communication easier.
Quick tool: “One question / one answer / written if needed.”
Brain fog: reduce the load — Coming soon My attention & memory supports — Coming soonFatigue & changing capacity FND can coexist with fatigue and other conditions.
Fatigue is common in people with persistent neurological symptoms, but fatigue can have many causes.
If you also have ME/CFS, migraine, pain, autonomic symptoms, sleep problems or another condition, these may affect how rehabilitation needs to be planned.
Quick tool: “What costs energy? / what causes symptoms? / what recovery do I need?”
Do not assume that every limitation is caused by FND. Coexisting conditions deserve their own assessment and treatment.
My activity & recovery record — Coming soon Fatigue, PEM & rehabilitation adjustments — Coming soonDiagnosis & positive clinical signs FND can be diagnosed positively.
FND should not be diagnosed simply because a scan or blood test is normal.
A neurologist or other appropriately trained clinician may identify positive clinical features during the examination.
Examples can include particular patterns of weakness or movement, or features of seizure-like episodes that are characteristic of FND.
The clinician should explain what they observed and how it supports the diagnosis.
A clear explanation can be an important part of treatment because it gives the person a framework for understanding their symptoms.
Testing may still be appropriate depending on the symptoms and clinical situation. FND can coexist with other neurological conditions.
FND & other conditions One diagnosis does not explain everything.
FND can occur alongside conditions such as migraine, epilepsy, multiple sclerosis, Parkinson’s disease, ME/CFS, chronic pain, hypermobility and other medical conditions.
Having an FND diagnosis should not prevent appropriate assessment of a new symptom.
Similarly, having another diagnosis does not automatically explain every neurological symptom.
Quick tool: “Is this my usual pattern? / is it new? / is it changing?”
A change in established symptoms deserves appropriate clinical attention.
Rehabilitation & treatment Education, rehabilitation and symptom-specific care.
Treatment is individualised according to the symptoms and the person’s goals.
Physiotherapy may help with functional movement symptoms. Occupational therapy can help with daily activities and participation. Speech and language therapy can help with appropriate communication, swallowing or voice symptoms.
Psychological therapies may be useful for some people, particularly when anxiety, trauma, depression or other difficulties are present. They should not be presented as proof that the neurological symptoms are imaginary.
Education about FND and understanding the mechanism of symptoms can itself be an important part of care.
Quick tool: “What symptom limits me most? / what matters to me? / what would improvement look like?”
Building my FND care team — Coming soon My FND rehabilitation goals — Coming soon Questions about my FND diagnosis — Coming soonLiving with FND Support participation without demanding perfect symptoms.
FND can affect work, education, relationships, travel, exercise and everyday tasks.
Helpful adjustments might include additional time, written instructions, flexible scheduling, reduced sensory load, mobility support or alternative communication.
The aim is not necessarily to eliminate every symptom before a person can participate in life.
Quick tool: “What matters? / what is getting in the way? / what adjustment would open the door?”
My needs & adjustments summary — Coming soon Making daily activities more accessible — Coming soonWhen symptoms suddenly change Don’t assume every new neurological symptom is FND.
FND symptoms can fluctuate, but sudden or substantially different neurological symptoms can also indicate another medical problem.
New facial weakness, new one-sided weakness or numbness, sudden difficulty speaking, sudden loss of vision, severe sudden headache, loss of consciousness, serious injury or other acute neurological symptoms may require urgent assessment.
Do not use an existing FND diagnosis to dismiss symptoms that are new, severe or clearly different from your usual pattern.
If you think you may be having a medical emergency in Australia, call 000.
FND & the ALPIMS domains Connections can be useful without assuming one cause.
FND symptoms: movement, sensation, speech, seizures and other neurological symptoms may be part of FND.
Sensory: sensory environments can affect comfort, attention and participation.
Pain & Laxity: pain, joint problems or hypermobility may coexist and may change rehabilitation needs.
Anxiety & Autonomic: autonomic symptoms, anxiety and FND may coexist, but dizziness, palpitations or fainting should not automatically be attributed to FND.
Mood & Trauma: psychological health can affect wellbeing and recovery, while FND does not require a psychological cause.
Capacity across domains: fatigue and reduced capacity can coexist with FND, including when another condition such as ME/CFS is present.
Immune: an allergy or inflammatory condition can add care needs and affect which environments or materials are tolerated. It needs its own assessment.
These are practical connections, not proof that one ALPIMS domain causes another.
FND & overlapping ALPIMS needs — Coming soonMore tools & resources Choose one next step.
External FND resources Choose a trusted source to explore.
External sites are independent of ALPIMS. UK and US service information may differ from Australian pathways. These resources support discussion with your clinician; they do not establish an individual diagnosis.
Disclaimer & your care General information and individual choice.
This page provides general education. It does not diagnose FND, provide personalised treatment or replace advice from your treating team. ALPIMS is an organising framework, not a diagnosis or diagnostic test.
FND symptoms are real and can be disabling. They should be taken seriously whether or not conventional tests show structural damage.
An FND diagnosis does not mean that every future symptom is FND. New, worsening or unexplained symptoms should be assessed appropriately.
Do not use this page to stop prescribed medication, replace medical assessment or assume that a symptom is psychological.
The prompts are ALPIMS suggestions, not validated clinical tests. Benefits and suitability vary. Rehabilitation should account for other conditions, including PEM where present. Linked organisations do not endorse ALPIMS.
Share only the personal information you choose. Before using an online tool, check how information is stored and shared.
For immediate danger or a medical emergency in Australia, call 000.