Functional Neurologic Disorder (FND) in Children and Young Adults: Symptoms, Causes, and Treatment
Functional Neurologic Disorder (FND) is a condition that affects how the brain sends and receives signals throughout the body. Although symptoms can look similar to other neurological conditions, FND is understood as a problem in nervous system functioning rather than structural damage to the brain or nervous system (Stone et al., 2020; Aybek & Perez, 2022).
Functional Neurologic Disorder is increasingly recognized by neurologists and mental health professionals, including in children, adolescents, and young adults. Symptoms can be frightening and disruptive, but many young people improve with appropriate treatment, especially when diagnosis is clear, treatment starts early, and care includes psychotherapy, rehabilitation, family support, and school support when needed (Kozlowska et al., 2023; Vassilopoulos et al., 2022).
At Ezer Psychotherapy, we provide compassionate, evidence-based therapy for adolescents and young adults experiencing conditions like FND.
What Is Functional Neurologic Disorder?
Functional Neurologic Disorder occurs when the brain has difficulty controlling movement, sensation, awareness, or other neurological processes. Unlike many neurological diseases that involve structural injury or degeneration, FND affects how the brain functions and communicates with the body.
In simple terms, the brain’s “software” is malfunctioning even though the “hardware” may appear intact.
FND may also be referred to as:
Functional neurological symptom disorder
Functional neurologic symptoms
Conversion disorder
Functional seizures
Psychogenic non-epileptic seizures (PNES)
Non-epileptic events (NEEs)
It is important to understand that FND symptoms are real and involuntary. Individuals are not faking symptoms or imagining them (Edwards et al., 2023; Stone et al., 2020).
Symptoms of Functional Neurologic Disorder in Children and Young Adults
Symptoms of FND vary widely and may develop suddenly or gradually.
Movement Symptoms
Tremors or shaking
Weakness in the arms or legs
Difficulty walking or abnormal gait
Muscle spasms or jerking movements
Sensory Symptoms
Numbness or tingling
Vision problems
Hearing changes
Seizure-Like Episodes
Some young people experience episodes that resemble seizures but are not caused by epilepsy. These are sometimes called functional seizures, psychogenic non-epileptic seizures, or non-epileptic events. Diagnosis often requires evaluation by a neurologist, and video EEG may be used when available (Kozlowska et al., 2023).
Cognitive and Physical Symptoms
Brain fog or difficulty concentrating
Fatigue
Headaches
Speech difficulties
These symptoms can interfere with school, sports, friendships, and everyday functioning.
How FND Impacts Children, Teens, and College Students
Functional Neurologic Disorder often appears during key developmental stages such as adolescence or early adulthood.
Young people with FND may struggle with:
School attendance or academic performance
Participation in athletics or extracurricular activities
Social relationships
Anxiety and frustration related to symptoms
Feeling misunderstood when medical tests appear normal
FND is not simply a diagnosis made after “everything else is ruled out.” Current guidance emphasizes that FND should be diagnosed using positive clinical signs and patterns that help “rule in” the condition (Stone et al., 2020; Perez et al., 2020).
What Causes Functional Neurologic Disorder?
There is rarely a single cause of FND. Instead, the condition usually develops through a combination of neurological, psychological, physical, relational, and environmental factors.
Potential contributing factors include:
Stress or emotional overwhelm
Anxiety or depression
Trauma or adverse life experiences
Physical illness or injury
Academic or athletic pressure
Nervous system dysregulation
Learned physiologic responses to specific stimuli
Psychological stressors can be important, but they are not required for an FND diagnosis. Some children and young adults do not identify a clear emotional trigger (Stone et al., 2020; Hallett et al., 2022).
Research suggests that FND involves changes in brain networks related to movement, attention, emotion, body awareness, and the sense of control over movement or sensation (Hallett et al., 2022; Kozlowska et al., 2023).
The encouraging news is that the brain is adaptable, meaning these patterns can change with treatment and practice.
How Psychotherapy Helps Treat Functional Neurologic Disorder
Psychotherapy is a key part of treatment for many children, teens, and young adults with FND. Therapy focuses on improving brain-body communication, regulating the nervous system, and addressing factors that may contribute to symptoms.
1. Education About the Brain-Body Connection
A major component of treatment is helping young people understand how FND works.
Learning that symptoms are real, brain-based, and potentially reversible can reduce fear and help individuals feel more hopeful about recovery (Kozlowska et al., 2023; Laptook, 2024).
2. Reducing Stress and Nervous System Dysregulation
Many individuals with FND have nervous systems operating in a heightened state of stress or threat.
Therapy may include skills such as:
Emotional regulation
Stress management
Mindfulness and grounding techniques
Body awareness exercises
These approaches help calm the nervous system and improve the brain’s ability to regulate physical symptoms.
3. Treating Anxiety, Trauma, or Emotional Stress
For some individuals, FND symptoms are linked to unresolved emotional stress, trauma, anxiety, depression, or chronic pressure.
Evidence-informed therapies may include:
Cognitive Behavioral Therapy (CBT)
Trauma-informed therapy
Family therapy
Skills for managing anxiety and stress
CBT and related approaches have shown promise in pediatric FND, including functional neurological symptoms and functional seizures (McFarlane et al., 2019; Vassilopoulos et al., 2022).
4. Supporting a Gradual Return to Daily Life
Recovery from FND often includes gradually returning to normal activities, such as school, sports, and social engagement.
Therapy helps young people:
Rebuild trust in their body
Reduce avoidance behaviors
Develop coping skills
Increase resilience
For motor symptoms, treatment may also include FND-informed physical therapy or occupational therapy. Multidisciplinary treatment is often recommended, especially when symptoms affect walking, movement, school attendance, or daily functioning (Kim et al., 2022; Kozlowska et al., 2021).
The Role of Family Support in FND Recovery
Family involvement is especially important when children or adolescents are experiencing Functional Neurologic Disorder.
Parents can help by:
Validating that symptoms are real
Encouraging gradual engagement in normal activities
Avoiding excessive focus on symptoms
Supporting therapy and treatment recommendations
Coordinating with schools and medical providers when needed
A supportive, coordinated environment can improve recovery and reduce confusion or fear around symptoms (Kozlowska et al., 2023; Watson et al., 2024).
When to Seek Therapy for Functional Neurologic Disorder
You may want to seek professional support if your child or young adult experiences:
Unexplained neurological symptoms
Seizure-like episodes without an epilepsy diagnosis
Difficulty walking or moving without a structural neurological explanation
Sudden weakness or tremors
Significant disruption to school or daily life
Any new seizure-like episode, sudden weakness, fainting, severe headache, new vision loss, or sudden neurological change should be medically evaluated promptly before assuming it is FND.
Early treatment can help young people regain functioning and confidence more quickly.
Therapy for Functional Neurologic Disorder at Ezer Psychotherapy
At Ezer Psychotherapy, we specialize in helping adolescents, young adults, and families navigate complex mental health and brain-body conditions.
Our therapists provide evidence-based virtual therapy designed to help clients:
Understand Functional Neurologic Disorder
Reduce stress and nervous system dysregulation
Address anxiety, trauma, and emotional stress
Build coping skills and resilience
Return to school, sports, and daily activities
We offer secure online therapy sessions for clients seeking specialized support for FND and related conditions in Minnesota, Wisconsin, North Dakota, and Florida.
Frequently Asked Questions About Functional Neurologic Disorder
Is Functional Neurologic Disorder a mental illness?
FND is often described as a brain-body or neuropsychiatric condition. While psychological stress can contribute to symptoms, FND involves real neurological functioning changes rather than symptoms that are “imagined” (Hallett et al., 2022; Stone et al., 2020).
Can people recover from FND?
Yes. Many children and young adults experience significant improvement, especially when treatment begins early and includes clear diagnosis, education, psychotherapy, rehabilitation, family support, and school support when needed (Kozlowska et al., 2021; Vassilopoulos et al., 2022).
Is therapy effective for FND?
Psychotherapy can be an important part of FND treatment. Therapy helps regulate the nervous system, address stressors, reduce avoidance, and support the brain in relearning healthier patterns of functioning. For many young people, therapy works best as part of a coordinated plan that may also include neurology, physical therapy, occupational therapy, school support, and medical care (Aybek & Perez, 2022; Kim et al., 2022).
Get Help for Functional Neurologic Disorder
If your child or young adult is experiencing symptoms of Functional Neurologic Disorder, you are not alone. With the right treatment and support, recovery is possible.
Ezer Psychotherapy offers compassionate, evidence-based therapy to help young people regain confidence, restore functioning, and move forward in their lives.
Schedule an appointment at Ezer Psychotherapy today.
References
Aybek, S., & Perez, D. L. (2022). Diagnosis and management of functional neurological disorder. BMJ, 376, o64.
Edwards, M. J., et al. (2023). Why functional neurological disorder is not feigning or malingering. Nature Reviews Neurology.
Hallett, M., Aybek, S., Dworetzky, B. A., McWhirter, L., Staab, J. P., & Stone, J. (2022). Functional neurological disorder: New subtypes and shared mechanisms. The Lancet Neurology, 21(6), 537–550.
Kim, Y. N., Gray, N., Jones, A., Scher, S., & Kozlowska, K. (2022). The role of physiotherapy in the management of functional neurological disorder in children and adolescents. Seminars in Pediatric Neurology, 41, 100947.
Kozlowska, K., Gray, N., Scher, S., & Savage, B. (2021). Psychologically informed physiotherapy as part of a multidisciplinary rehabilitation program for children and adolescents with functional neurological disorder. Journal of Paediatrics and Child Health, 57(1), 73–79.
Kozlowska, K., Chudleigh, C., Savage, B., Hawkes, C., Scher, S., & Nunn, K. P. (2023). Evidence-based mind-body interventions for children and adolescents with functional neurological disorder. Harvard Review of Psychiatry, 31(2), 60–82.
Laptook, R. (2024). The importance of language and messaging in psychological treatment for functional neurological disorder in children and adolescents. Rhode Island Medical Journal, 107(11), 14–18.
McFarlane, F. A., Allcott-Watson, H., Hadji-Michael, M., McAllister, E., Stark, D., Reilly, C., Bennett, S. D., McWilliams, A., & Heyman, I. (2019). Cognitive-behavioural treatment of functional neurological symptoms in children and adolescents: A case series. European Journal of Paediatric Neurology, 23(2), 317–328.
Perez, D. L., Aybek, S., Popkirov, S., et al. (2020). A review and expert opinion on the neuropsychiatric assessment of motor functional neurological disorders. Journal of Neuropsychiatry and Clinical Neurosciences.
Stone, J., Burton, C., & Carson, A. (2020). Recognising and explaining functional neurological disorder. BMJ, 371, m3745.
Vassilopoulos, A., Mohammad, S. S., Dure, L. S., et al. (2022). Treatment approaches for functional neurological disorders in children. Current Treatment Options in Neurology.
Watson, M., Kreuzman, J., Zeribi, K., Iskander, J. M., Hopper, A., Simon, L., Chesley, G., & Fobian, A. (2024). The current state of pediatric functional neurological disorder treatment in the United States. Pediatric Neurology, 158, 144–155.
