Diagnostic Overshadowing
Posts exploring how an FND diagnosis may influence subsequent clinical reasoning, potentially leading symptoms, findings, or alternative diagnoses to be overlooked, discounted, or insufficiently investigated.
Nine Specialists Challenge the Conflation of POTS, Dysautonomia and FND
FND Nope
Moderator
Nine medical specialists warn that POTS and other autonomic disorders are being confused with FND, exposing patients to misdiagnosis, diagnostic overshadowing and potentially inappropriate rehabilitation. Their 2024 paper examines the diagnostic evidence, comorbidity claims and consequences of treating physiological disorders as functional.
Medication, Polypharmacy and FND: What the Research Reveals and What Remains Unanswered
FND Nope
Moderator
A study of 322 motor FND patients documented extensive medication prescribing, substantial polypharmacy and concerns about potential iatrogenic harm. Beyond the numbers lie important questions about adverse drug effects, diagnostic reasoning and whether subsequent research has adequately addressed these risks.
18 Months of Neurological Decline, a Psychosomatic Label, and the Lyme Infection They Missed
FND Nope
Moderator
A 54-year-old woman spent more than 18 months experiencing progressive neurological symptoms before doctors identified late Lyme neuroborreliosis and spinal cord inflammation. Her symptoms had been attributed to psychosomatic causes, despite worsening mobility, bladder and bowel dysfunction, and significant weight loss. A 2025 case report documents the diagnostic delay, the evidence that overturned the earlier assumption, and the lasting disability after treatment.
The MRI Was Normal. The Lesion Was Still There.
FND Nope
Moderator
Studies using 7 Tesla MRI have uncovered neurological lesions missed by conventional scans, sometimes confirmed through surgery and pathology. So how much confidence should clinicians place in a normal MRI, and what happens when they decide patients do not need imaging at all?
“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 Everything Looks Functional: Ten Claims, One Convenient Diagnosis
Quackademic
ME/CFS? Stop pacing. Long COVID? Think functional. POTS, MCAS or CCI? Perhaps FND. We examine ten controversial public statements from an FND-specialist physical therapist, the evidence behind them, and the potential consequences for patients.
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.
Marion Brown: Challenging the Misdiagnosis of Antidepressant Withdrawal as FND
FND Nope
Moderator
Marion Brown, a retired Scottish psychotherapist and friend of this website, has spent years exposing how antidepressant withdrawal and adverse drug reactions can be overlooked, dismissed, or misdiagnosed as Functional Neurological Disorder and medically unexplained symptoms. We examine her research, parliamentary advocacy, and the patient experiences behind her work.
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.
When Drug-Induced Neurological Damage Gets Labelled FND
FND Nope
Moderator
Psychiatrist David Healy challenges the use of FND diagnoses in patients experiencing persistent medication-related neurological symptoms, warning that drug toxicity can be overlooked, patients dismissed and potentially harmful treatments repeated.
