Rule-In Signs
Posts examining the positive signs, diagnostic criteria, and clinical features used to support a diagnosis of Functional Neurological Disorder, including their strengths, limitations, and interpretation.
FND: New Name, Same Old Problems?
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FND is celebrated as an area of medical progress, but how much has actually changed? Historical research reveals continuity with hysteria and conversion disorder, while modern diagnostic uncertainty and limited treatment breakthroughs raise questions about whether institutional recognition has outpaced meaningful progress for patients.
From PNES and Suspected FND to C1 Paralysis: Amy Wang-Hiller's Story
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Violinist Amy Wang-Hiller describes how suspected FND, a PNES diagnosis and repeated psychological attribution allegedly delayed recognition of tethered spinal cord, cervical instability and progressive paralysis.
FND Diagnostic Pitfalls: When Positive Signs Point Elsewhere
FND Nope
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A 2023 review by FND researchers acknowledges that Hoover's sign, distractibility, sensory abnormalities and other supposedly characteristic findings can occur in recognised neurological diseases. What does that mean for diagnostic certainty?
False Positive Hoover's Sign in Apraxia: A Case of Corticobasal Syndrome
FND Nope
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A 2020 clinical case reports positive Hoover's and hip abductor signs in a woman diagnosed with corticobasal syndrome. The authors identify apraxia as an alternative explanation, exposing an important limitation in the diagnostic interpretation of signs associated with functional neurological disorder.
Jo Puckett's FND Story in the Daily Mail: Questions Worth Asking
FND Nope
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A Daily Mail article about Jo Puckett's experience with FND raises questions about diagnostic certainty, psychological distress, medical dismissal and the difference between wanting answers and wanting to remain ill.
Why We Share These Stories
FND Nope
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Why FND Nope shares patient stories, diagnostic reversals and clinical cases: not to win an argument, but to preserve uncertainty, uncover possible clues and keep doors open when people are still sick.
Four Years of Dystonia: Meige Syndrome Misdiagnosed as FND
FND Nope
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A 2024 case report describes a 42-year-old woman diagnosed and treated for FND despite persistent facial, oral and cervical movements. After treatment failed, neurology diagnosed Meige syndrome. The authors explicitly describe the original FND diagnosis as a misdiagnosis.
When an Unexplained Gait Became Conversion Disorder: A Huntington’s Disease Case
FND Nope
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A 65-year-old woman with an abnormal gait, cognitive decline and psychiatric symptoms was diagnosed with conversion disorder after inconclusive neurological investigations. Years later, genetic testing confirmed Huntington’s disease—raising a difficult question: what positive evidence had established conversion disorder in the first place?
When FND Overshadowed an Axonal Neuropathy: A Case of AMSAN
FND Nope
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A 22-year-old woman entered rehabilitation with FND as her primary diagnosis while an underlying acute motor and sensory axonal neuropathy (AMSAN) remained unrecognised. EMG and nerve conduction studies later demonstrated extensive axonal damage, leading to IVIG treatment and improved rehabilitation progress. The authors explicitly describe the case as diagnostic overshadowing.
When Suppressible Movements Were Called Functional: A Genetic PKD Case
FND Nope
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A 14-year-old boy was diagnosed with a functional movement disorder after presenting with suppressible involuntary movements and psychiatric comorbidity. Further investigation identified monogenic paroxysmal kinesigenic dyskinesia (PKD), while the authors noted that specific positive features supporting the original functional diagnosis had been absent.
