Functional neurological disorder: Resetting the brain’s 'software'

Functional neurological disorder (FND) — previously known as conversion disorder — is a brain‑based condition in which the nervous system has difficulty sending and receiving signals correctly. Although the brain and body themselves are structurally healthy, disruptions in how the brain functions can lead to very real and often disabling symptoms, such as changes in movement, sensation or awareness.

Unlike neurological conditions caused by injury or disease to the brain’s structure (the “hardware”), FND reflects a problem with how the brain operates the “software.” FND is one of the most common reasons for neurological symptoms in children and adolescents.

FND symptoms can be triggered by issues with physical health, stressful events or emotional or physical trauma. Examples could include:

• Having spells that look like seizures when experiencing strong emotions, even excitement and happiness

• Experiencing episodes of losing consciousness after having a scary moment of dizziness or nearly hitting your head

• Being able to move your legs to put on socks and shoes but being unable to stand up or walk after a skiing accident

• Experiencing weakness in your arms and legs, making it difficult to perform daily activities, after having flu for a week

• Having trouble walking after visiting a family member in the hospital who just had an amputation

• Experiencing an increase in spells after a major change in routine, such as going back to school after a break

If your child is diagnosed with FND, it's important to know that their brain and body do not have physical problems. The problem is in the brain-body connection. Symptoms can be severe; however, with early diagnosis and a supportive, multidisciplinary approach, most children and teens experience significant improvement or full recovery.

Functional or non-epileptic seizures (also called spells) are among the most common FND symptoms. These look like a seizure but are medically different from epileptic seizures. Epilepsy is caused by abnormal electrical activity in the brain. However, people with FND have normal electrical brain activity.

Other possible symptoms of FND include:

• Tremors, twitches, jerks or shaking that is hard to control.

• Weakness or paralysis

• Slurred speech

• Brain fog

• Dizziness or loss of balance

• Hearing or vision loss

Our UW Health Kids FND care team brings together experts across multiple specialties to provide coordinated, comprehensive care. Our team includes clinicians in psychology, neurology, psychiatry, physical therapy, occupational therapy and speech‑language pathology — all working together to support your child and family.

Our treatment journey begins with a two‑hour intake session designed to understand your child’s symptoms, experiences and goals. We then explain how FND affects the brain and body using age-appropriate language and visual aids. We also partner with families to set realistic goals focused on symptom management and a gradual return to valued daily activities.

Your child’s treatment plan is tailored to their specific needs and could include:

• Cognitive‑behavioral therapy (CBT), which helps children understand body sensations, reduce fear and worry about symptoms, challenge unhelpful thought patterns and build coping skills.

• Active rehabilitation (physical and occupational therapy) that focuses on retraining movement and function while encouraging confidence, independence and a sense of control over the body.

• Speech therapy for speech or swallowing difficulties

• Family and school support to reinforce helpful strategies at home and in the classroom to help children return to their normal routines

Most children and adolescents attend three to 12 sessions, with ongoing support as needed. Research shows that early care and a positive, supportive approach are keys to recovery.

We're eager to support you in reaching your symptom management goals and achieving an improved quality of life.

Our multidisciplinary team brings together expertise in child psychology, neurology, psychiatry, rehabilitation and therapy to provide comprehensive care for children and adolescents with FND.