Common Motor Manifestations
Motor symptoms are among the most common reasons for an FND diagnosis. They often affect one side of the body or a specific limb, and can resemble symptoms of a stroke or Parkinson's disease.
Functional Weakness
A patient may feel like a limb is heavy, paralyzed, or lacks strength. Unlike structural weakness, this weakness often fluctuates and can be "vulnerable" to specific movements.
Functional Tremor
A rhythmic shaking that often becomes more severe when the person focuses on it, but may dampen or disappear entirely with distraction or during specific tasks.
Gait Disorders
Walking difficulties that may appear as dragging a leg, walking with a wide base, or feeling like the floor is "unstable." This is often called "astasia-abasia."
The Role of Distraction
A unique feature of motor FND is that symptoms often improve when the patient's attention is shifted elsewhere. For example, a tremor in the right hand might stop if the patient is asked to perform a complex tapping task with their left hand.
Clinical Sign: Hoover's Sign
Functional Limb Paralysis
Sometimes a limb can become completely "paralyzed" in FND. Even in these cases, the brain's hardware is fine. The brain is effectively "ignoring" the signal to move that limb. Physical therapy involves "re-introducing" the limb to the brain's map.
Management Strategies
- Distraction Techniques: Learning to "ignore" the symptom to allow the brain to reset.
- Gait Training: Retraining the automatic walking patterns that have been lost.
- Mirror Therapy: Using visual cues to help the brain recognize movement in a paralyzed limb.