Functional Neurological Disorder

four circles with star heart, people and arrow icons inside

Children's Functional Neurological Disorder

What is Functional Neurological Disorder (FND)?

Functional Neurological Disorder (FND) is a condition that affects how the brain and body communicate with one another.

Children and young people with FND experience genuine neurological symptoms, but these symptoms are not caused by damage or disease of the nervous system. Symptoms can affect movement, sensation, speech, concentration, fatigue and many other areas of daily life.

FND is a common condition and can often improve with the right support and treatment.

Our team works with children, young people and their families to understand symptoms, develop effective management strategies and support recovery. 

What should I do if I think my child may have FND?

If you think your child may be experiencing symptoms that could be related to Functional Neurological Disorder (FND), it is important to seek medical advice. Symptoms such as weakness, unusual movements, episodes of altered awareness, difficulties with walking, or changes in speech and sensation should always be assessed by a healthcare professional.

The first step is usually to speak to your GP, consultant or another healthcare professional involved in your child's care. They can assess your child's symptoms and, where appropriate, refer them to the most suitable service for further evaluation.

Many symptoms associated with FND can also occur in other neurological or medical conditions, so it is important that your child receives a thorough assessment before a diagnosis is made.

While waiting for appointments, it can be helpful to:

  • Keep a record of symptoms, including when they occur and any triggers.
  • Take videos of episodes or movements where appropriate, as these can sometimes help clinicians understand what is happening.
  • Maintain normal routines, including school attendance and activities, where possible and safe to do so.
  • Seek support from healthcare professionals if symptoms are affecting your child's wellbeing, education or daily life.

Remember that FND is a genuine condition. The symptoms are real and can have a significant impact on a child's life, but with the right support many children and young people improve over time.

How can we help?

Treatment for FND is tailored to each child or young person's symptoms and needs. Support may include:

  • Understanding FND and how symptoms develop.
  • Physiotherapy and Occupational Therapy.
  • Advice on returning to school and everyday activities.
  • Emotional wellbeing support.
  • Support for parents and carers.
  • Working with education and community services to help maintain progress and recovery.

Psychology and emotional wellbeing support

Living with FND can affect emotional wellbeing as well as physical health.

We work closely with local Child and Adolescent Mental Health Services (CAMHS) and can signpost families to appropriate support where needed. We also recommend accessing accredited psychological support services when appropriate. 

Additional support

Choose well for mental health – children and young people : a guide to help children and young people (aged 18 and under) in Barnsley, Calderdale, Kirklees and Wakefield to ‘choose well’ when looking after their mental health and wellbeing.

The FND Workbook for Kids & Teens: A Brain-Based Approach by Katie Carey and Meagan Watson: A workbook for children and young people living with FND, focusing on understanding symptoms, building skills and supporting recovery. Please note this is an external resource and not produced by the NHS.

The FND Companion: A Support Workbook for Kids and Teens Living with Functional Neurological Disorder: a practical workbook, created by a mum and her daughter, to help children and young people understand FND, manage their emotions and build confidence through creative activities and coping strategies. Please note this is an external resource and not produced by the NHS.

Coping with Functional Neurological Disorder: Listening to your Body, Finding Balance and Moving towards Recovery: accessible explanations of FND and practical wellbeing strategies, written by a clinical psychologist with lived experience of the condition. Please note this is an external resource and not produced by the NHS.

Information for patients and families

Understanding Functional Neurological Disorder (FND)

FND can affect children and young people in different ways. Symptoms are real, involuntary and can have a significant impact on daily life, school, friendships and family activities.

Some children experience one symptom, whilst others experience several. Common symptoms include functional seizures, weakness, difficulties with movement, tics, tremors, sensory changes, fatigue and pain.

Although symptoms may appear unusual, they are genuine and are not being consciously produced or controlled by the child or young person.

Weakness and movement difficulties

Some children and young people experience weakness in an arm, leg or one side of the body. This may affect walking, balance, coordination, handwriting or participation in everyday activities.

The weakness is real and can sometimes vary throughout the day. Some young people may also experience difficulties with movement, tremors, muscle spasms or problems with coordination.

Tics and involuntary movements

Some children and young people with FND experience sudden movements, sounds or vocalisations that feel difficult or impossible to control. These symptoms may be referred to as functional tics or involuntary movements.

Tics and movements can sometimes become more noticeable during periods of stress, excitement, illness or fatigue. As with other FND symptoms, they are not deliberate or attention-seeking and can be distressing for the child or young person experiencing them.

Understanding functional seizures

Functional seizures are episodes that can affect movement, awareness, sensation or responsiveness. Although they can look similar to epileptic seizures, they are not caused by abnormal electrical activity in the brain.

Functional seizures are real, involuntary and can be frightening for both the child or young person and those around them. They are often linked to the way the brain and body respond to stress, worries, emotions, illness, pain or difficult experiences.

What should I do during an episode?

The most important thing is to stay calm and focus on safety.

  • Help keep the child or young person safe from injury.
  • Stay with them and offer reassurance.
  • Reduce noise and distractions where possible.
  • Speak calmly and gently.
  • Avoid restraining them unless there is an immediate risk of harm.

Most functional seizures will pass on their own.

Are functional seizures dangerous?

Functional seizures can be distressing, but they are not usually harmful. They do not cause damage to the brain and most children and young people recover well with the right support and understanding.

If you are worried that symptoms are different from usual, or there is an injury or another medical concern, seek advice from a healthcare professional.

Recovery and support

Many children and young people see improvements over time. Recovery is often helped by:

  • Understanding the diagnosis.
  • Learning ways to manage stress and anxiety.
  • Support from family, school and healthcare professionals.
  • Returning to normal activities where possible.
  • Developing confidence and coping strategies.

How can parents and carers help?

Parents, carers and loved ones play an important role in recovery.

You can help by:

  • Providing reassurance and emotional support.
  • Encouraging normal routines where appropriate.
  • Listening to any worries or concerns.
  • Working with healthcare professionals and schools.
  • Helping the child or young person use coping and grounding techniques.

Where can I find more information?

If you have questions about FND or functional seizures, please speak to your healthcare team. They can explain your child's diagnosis, discuss support options and signpost you to appropriate services. Understanding the condition is an important first step towards recovery.

Information for schools

We understand that FND can affect attendance, learning and participation in school life.

We work with schools and education professionals where appropriate to help children and young people remain engaged in education and to support a successful return to school.

Useful resources for schools include:

Support for siblings

FND can affect the whole family, including brothers and sisters.

Siblings may:

  • Feel worried or confused about what is happening.
  • Feel upset when family routines change.
  • Have questions about symptoms they have witnessed.
  • Feel overlooked if parents or carers need to spend more time supporting the child with FND.

Parents and carers can help by:

  • Providing age-appropriate explanations about FND.
  • Encouraging siblings to ask questions and share their feelings.
  • Reassuring siblings that FND is not contagious and is nobody's fault.
  • Making time for individual activities and conversations with siblings where possible.
  • Seeking additional support if siblings are struggling emotionally.

It can be helpful to remind siblings that although symptoms may sometimes appear unusual or unpredictable, they are real experiences for the child or young person affected by FND.

Families often find that open communication and involving siblings in discussions about care and recovery helps everyone feel more supported and informed.

Other sources of support

Digital tools

vCreate
V-create is a secure video platform where videos can be uploaded and reviewed by the epilepsy team. To register for an account, please complete the following form and email it to your child’s consultant's secretary as below: V-create set up form - downloadable form (not accessible).docx [docx] 14KB

Tactuum
Tactuum is a secure digital platform that allows patients and families to complete questionnaires online, including the Strengths and Difficulties Questionnaire (SDQ), which can then be reviewed by clinicians involved in your child's care. 

Useful resources

Understanding FND

West Yorkshire Healthier Together
Visit the Healthier Together website for information and resources relating to functional symptoms in children and young people. 

Additional support and resources
Many children and young people with FND may also benefit from information and support relating to associated symptoms or conditions, including: