Christoff Truter
Posts
37
When Nursing Education Reinforces a Diagnosis
Does this nursing guide teach observation, or does it teach reinforcement of a diagnosis? A critical examination of how skepticism, alternative diagnoses, and diagnostic uncertainty are presented to nursing staff.
The Common Phenotypes Hypothesis
An exploration of FND, positive rule-in signs, comorbidity, predictive processing, diagnostic closure, and whether functional symptoms may reflect common phenotypes arising from multiple underlying conditions.
The Belief Prerequisite: How FND Treatment Echoes Faith Healing
One of the most striking things you notice when you first start reading the literature on FND is how crucial it is considered for patients to accept and believe in the diagnosis. Without that belief, treatment is often regarded as futile. They simply will not get better.
What Makes a Doctor a Good Doctor?
A reflection on what makes a good doctor in the context of complex chronic illness, focusing on collaboration, systems thinking, and clinical humility.
Fatigable Weakness vs Functional Weakness: Why Hoover’s Sign Can Mislead When Isokinetic Testing Shows Otherwise
Examines Hoover's sign in a patient with true fatigable weakness. Highlights how objective isokinetic testing better captures performance deficits than traditional clinical signs, preventing misinterpretation as functional weakness.
When Diagnosis Becomes Doctrine: Questioning FND and Clinical Authority
When I started this website in July 2025, I received a lot of pushback from FND proponents. Some felt that the website was highly offensive and disrespectful, and urged me to please take the website down, which I obviously did not do.
FND's Flawed Analogy: When 'Software' Problems can Hide Undetected Hardware Damage
One of the most common analogies that you would come across within FND literature is the software/hardware analogy.
If FND Scepticism Feels Like a Personal Attack, It Might Be Time for Introspection
FND patient communities provide support but risk echo chambers: illness becomes identity, criticism feels like attack, closing doors to misdiagnosis & recovery—modern hysteria protected by groupthink.
Advice from an FND Sceptic for Those Newly Diagnosed
What advice would I give to anyone newly diagnosed with this disorder? Advice that I wish I had received back then?
Why Calling It FND Can Be Misleading and Potentially Dangerous
As you might have noticed by now, I am not particularly convinced of the legitimacy of FND as a standalone diagnosis. I believe it is more likely a CNS knee-jerk reaction or referral to underlying causes, rather than a primary cause in itself. In other words, it may be something commonly observed as a consequence of an underlying illness (as pain is to fractures), not something that should automatically be treated or diagnosed as the illness itself, as is increasingly common practice these days.
Comments
38- Relentlessly progressive course steadily accumulating symptoms over months with no sustained improvement or fluctuation. Classic FND is typically variable, waxing and waning, and often shows periods of spontaneous improvement.
- Prominent encephalopathic features delirium, psychosis, catatonia, and rapid cognitive/personality change. These are not core features of FND and are far more suggestive of underlying organic brain dysfunction, such as autoimmune or inflammatory encephalitis.
- Objective hard neurological signs positive Hoffmann's sign and MRI findings of demyelination described as too much for age. FND is a technically a diagnosis of exclusion that requires symptoms to be incompatible with recognised organic disease.
- Lack of documented positive FND signs for most symptoms only leg weakness appears to have had such signs recorded. Surely a robust FND diagnosis should document specific rule in signs (e.g., Hoover's sign, entrainment, give way weakness, etc.) for each major complaint.
- Clear post infectious trigger plus strong family autoimmune history both are well established risk factors for autoimmune encephalitis and other neuroinflammatory conditions that require proper rule out, not dismissal.
- Psychiatrist explicitly ruled out primary psychiatric disorder this significantly weakens any trauma based or psychogenic explanation for the neurological picture (for those following the CD model that is sometimes still used in FND).
Discussions started
2You can literally go onto https://fndconnect.org.uk/shop/product/fnd-connect-i-have-seizures-lanyard-and-card
And for £ 4.99 you can buy yourself a lanyard to inform bystanders to effectively discourage appropriate emergency care.
Someone may assume every episode is "just another functional seizure." But seizures can change, suffer a head injury, have a stroke,
low blood sugar, cardiac syncope, or another medical emergency.

Looking back, was there a symptom(s) that should have prompted doctors to investigate further before diagnosis FND?