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 Fundamentalists”: New Study Exposes Deep Divisions Over Functional Neurological Diagnoses
FND Nope
Moderator
An international study involving 1,853 patients and 400 clinicians reveals profound disagreements over FND diagnoses in autoimmune disease, reports of diagnostic overshadowing, and clinical reasoning that raises important questions about whether neurological symptoms attributed to FND may have different underlying causes.
When Hoover's Sign Suggested Conversion Disorder, but Lyme Disease Entered the Picture
FND Nope
Moderator
A 2019 case report documents a woman whose weakness, anxiety and reported positive Hoover's sign raised suspicions of conversion disorder. Further investigations uncovered objective neurological abnormalities and evidence supporting possible Lyme neuroborreliosis.
When Lyme Disease Symptoms Persist: What Do We Actually Know?
FND Nope
Moderator
Lyme disease can have lasting consequences, but persistent symptoms do not necessarily mean persistent infection. We examine untreated infection, reinfection, treatment limitations, PTLDS and the difficult questions raised when patients with unresolved neurological symptoms receive an FND diagnosis. Drawing on published research, patient accounts and discussions on FND Nope, we also explore how clinical terminology can obscure rather than clarify diagnostic uncertainty.
Diagnosed With FND After Negative Genetic Tests. The Patient Actually Had Spinocerebellar Ataxia.
FND Nope
Moderator
A patient spent years with neurological symptoms, repeated falls and fractures while doctors attributed his condition to FND and other functional diagnoses. New genetic testing eventually identified SCA27B. A published three-patient case series exposes the dangers of negative investigations, diagnostic confirmation bias and assuming neurological presentations must fit existing expectations.
17 Patients Diagnosed With Psychogenic Seizures. All 17 Had Evidence of Autonomic Dysfunction
FND Nope
Moderator
A September 2026 study examined 17 patients diagnosed with psychogenic non-epileptic seizures. All had abnormal orthostatic findings, and 10 of 14 patients receiving medication improved after treatment for autonomic dysfunction. Some had visited emergency departments up to seven times before further neurological assessment. The findings raise serious questions about premature PNES diagnoses and missed physiological causes of seizure-like movements.
Diagnosed With FND, Her Tilt-Table Test Was Cancelled. Doctors Later Discovered Severe Autonomic Dysfunction
FND Nope
Moderator
A 43-year-old woman became unable to stand during a COVID-19 infection. Doctors diagnosed FND and cancelled her scheduled tilt-table test. Twelve days later, testing revealed her blood pressure collapsing to 66/52 mmHg. Further investigations identified evidence of immune-mediated autonomic dysfunction, and she eventually recovered following treatment.
Diagnosed With FND, Died From a Pulmonary Embolism: The Questions Allison Lawlor's Story Raises
FND Nope
Moderator
Allison Lawlor lived with severe neurological symptoms, received an FND diagnosis and later died from a pulmonary embolism. Her story raises important questions about diagnostic uncertainty, thromboembolic risk and why patients owe no loyalty to a diagnosis.
Diagnosed With FND. It Was Buerger's Disease. She Lost Her Leg
FND Nope
Moderator
Danielle Thomas reported numbness, worsening walking difficulties and legs that felt like they were dying. Doctors diagnosed FND. Months later, vascular investigations revealed blocked arteries, gangrene and Buerger's disease. She eventually underwent a below-knee amputation.
Dismantling FND: When ME/CFS Starts Trespassing on Functional Neurology's Territory
FND Nope
Moderator
Dr. Brayden Yellman and Paige Zuckerman challenge FND, its diagnostic assumptions, and its overlap with ME/CFS. From seizure-like episodes explained by orthostatic intolerance to patients receiving alternative diagnoses, the question is simple: what happens when medicine starts explaining symptoms previously called functional?
10 Suspicious Things You Apparently Shouldn't Do Around an FND Specialist
Quackademic
Sunglasses, wheelchairs, handwritten notes, music and even office chairs have all found their way into medical discussions of functional neurological symptoms. The real problem isn't that these observations necessarily diagnose FND, but that they can influence the wider clinical picture. A sarcastic, referenced tour of ten examples where ordinary behaviour risks becoming suspicious.
