Clinical Reasoning
Posts exploring how clinicians interpret symptoms, evidence, uncertainty, and patient narratives when forming, questioning, or revising a diagnosis.
94.4% of Ehlers–Danlos Patients Reported Psychiatric Labelling or Dismissal. Two-Thirds Reported Conversion Disorder
FND Nope
Moderator
A 2025 study of 429 patients with hypermobile Ehlers–Danlos syndrome found that 94.4% reported psychiatric labelling or accusations of fabrication, while 66.7% reported a previous conversion disorder diagnosis. The findings raise serious questions about diagnostic dismissal, medical credibility and missed physical illness.
Four Years Diagnosed With FND Before a DaTscan and Parkinson's Diagnosis
Reddit Stories
Social media
A Reddit user reports spending four years diagnosed with FND before receiving a Parkinson's disease diagnosis following a DaTscan. They say appropriate medication improved their condition, raising questions about the original diagnosis and the consequences of delayed investigation.
When a Genetic Neurological Disorder Was Considered Functional: The FLVCR1 Case
FND Nope
Moderator
A woman with progressive neurological symptoms and documented FLVCR1 variants repeatedly had her symptoms considered functional. A 2026 case report exposes a failure to connect neurological findings with an existing genetic disorder.
When Defending FND Means Missing the Point
Quackademic
David Healy's warning that drug toxicity can disappear behind an FND diagnosis has provoked predictable criticism. But much of the response confuses how FND is supposed to be diagnosed with how it is actually diagnosed. The literature itself shows misdiagnosis, overdiagnosis and diagnostic overshadowing occur. You can dislike Healy's language. You still have to answer his argument.
FND, Until It Was Inoperable Tongue Cancer
FND Nope
Moderator
A 58-year-old woman with progressive swallowing and speech problems was diagnosed with functional movement disorder. Eleven months after onset, repeat imaging found advanced squamous-cell carcinoma. The authors say diagnostic bias from the FMD diagnosis even caused abnormal swallowing findings to be misinterpreted.
FND Hope's Founder, a Misdiagnosis, and Sneddon's Syndrome
FND Nope
Moderator
FND treatment is built around assumptions about why symptoms occur. But what happens when those assumptions are wrong? Bridget Mildon's Sneddon's syndrome and Rebel's later ALS diagnosis raise an uncomfortable patient-safety question: how safe is mechanism-specific treatment when the mechanism itself remains uncertain?
I Am Angry
Christoff
Spousal caregiver
I am angry that uncertainty became certainty, that softened language obscures what is actually being claimed, that scepticism is treated as hostility, and that while we argue about FND, my wife keeps getting sicker.
Inside the Reasoning of an FND Professional
Quackademic
We examined repeated public claims about FND made by an allied health professional who treats the disorder for a living. Some are supported by the literature. Others go much further than the evidence allows. The recurring problem is simple: evidence seems much better at confirming FND than disproving it.
POTS Found After FND: Comorbidity, or a Common Phenotype?
FND Nope
Moderator
An FND case report found objective POTS after years of orthostatic symptoms were attributed to FND, anxiety and deconditioning. The authors call it comorbidity. But the case leaves a more important question unanswered: are the “functional signs” really evidence of a second disorder?
The Diagnosis of the Gaps: FND and the Problem of Phenotype Overlap
Quackademic
Davenport et al.’s comparison of Long COVID, ME/CFS and FND has drawn criticism, but some apparent errors expose a deeper problem: when FND can resemble almost every common neurological phenotype, definitions can determine the answer before the differential even begins.
