jakovmrc
Posts
1
The FND quacks think that bringing a list of written notes to your appointment is near-certain proof that you have a psychosomatic disorder
A critical examination of the evidence behind so-called “rule-in signs” for Functional Neurological Disorder, focusing on the claim that bringing written notes to an appointment strongly indicates a psychosomatic condition.
Comments
11@Con Bradley What you've described could also be brain fog from long covid or similar disease. A lot of people describe things like that. If you google executive dysfunction you'll see a description, that symptom also appears in things like ADHD.
The fact that it started in the early years of covid (what you call during covid) is telling. One possibility is that you had covid but it was very mild (perhaps you just had a runny nose one day). Asymptomatic covid infections can give people long covid (eg https://www.mdpi.com/1660-4601/20/2/1613)
In practical terms what you could do is try to get a PET scan of the brain. If you look at this paper (https://doi.org/10.1007/s00259-022-06013-2) it has a lot of details. Or put "long covid brain hypometabolism" into google scholar and there are many other papers. The way you get a PET scan is to go to a neurologist, and lie a little bit, say you're sure you have long covid and that ever since you got sick with covid you've had these symptoms, and that you read online that people with long covid with your symptoms often have abnormal results on a PET scan, then show them the above paper and ask if you could have a scan like the one in the paper. One complication is that since you have a FND diagnosis on your medical records doctors will often use this as an excuse to refuse you any scans, so you might have to try different places or something.
The fact that this stops you working is really bad.
If your short of cash one suggestion is to get a PET scan in a cheaper country you fly to, for example Bulgaria or Turkey. You could do a telemedicine consultation at home, then fly there and back on the same day. The cash aspect is a really nasty part of this whole FND business that people with more more can simply buy their way out of being fobbed off with an FND diagnosis, while people with less money have to lump it.
You could do a nasa lean test (https://batemanhornecenter.org/wp-content/uploads/2016/09/NASA-Lean-Test-Instructions-1.pdf) to check for POTS, which is a possible cause of the symptoms you describe. This thing about memory and concentration problems sounds like brain fog. If you have POTS it would be caused by reduced blood flow to the brain.
@Anonymous
By my reading your academic.oup. link does not support your claim. It also has the incorrect assumption that people cannot have both Lyme and ME/CFS at the same time. You can see when people in that study cohort got a CFS diagnosis its assume (wrongfully) that they actually didnt have lyme. In fact we know that a significant number of people with post-treatment lyme disease syndrome fulfil the diagnostic criteria for ME/CFS (https://pmc.ncbi.nlm.nih.gov/articles/PMC10497844/) which is similar to how a lot of people with long covid also have ME/CFS (eg https://www.sciencedirect.com/science/article/pii/S0163445324002317).
Your claim that "the international scientific consensus that “chronic Lyme disease” does not exist" is a very strong claim. It only takes me finding ONE scientist working in the field who thinks chronic lyme is real to refute the idea of consensus. And here is one, Amy Proal, PhD.
https://x.com/microbeminded2/status/2034705144873357672
You can see in this little video she's talking about how she's a microbiologist working on long covid, chronic lyme and similar diseases, and talking about how the tests we currently have are not very good and we need to develop better ones. If you search Amy Proal's twitter you can find many other instances of her talking about chronic lyme disease as a real legitimate entity. So there you have it, there is no consensus against chronic lyme, in fact it's controversial with arguments in both ways. Although its true that there is are randomised controlled trials showing that antibiotics are effective for chronic lyme.
However since we're talking about randomised controlled trials, look at this paper (https://pmc.ncbi.nlm.nih.gov/articles/PMC7850207/) titled "A practical review of functional neurological disorder (FND) for the general physician". It says
There remains an absence of evidence to support any specific treatment approach for functional cognitive disorders. Clinical experience suggests that a cognitive behavioural approach may be helpful
Read that again. ABSENCE OF EVIDENCE. In other words FND/FCD is exactly as quackery as chronic lyme in this respect. Both have a controversy of whether they even exist, and both have no treatments backed by randomised controlled trials.
The comment is talking about Lyme neuroborrelios but this is distinct from the hypothesised chronic lyme, and the symptoms and signs will be different. Similar to how acute covid symptoms are often different to long covid symptoms.
If @Anonymous really is Anonymous Neurologist, then that means they've commenting a lot on many posts on this website. I've noticed that they have not commented on my post (https://fndnope.org/posts?postId=64) called "The FND quacks think that bringing a list of written notes to your appointment is near-certain proof that you have a psychosomatic disorder". The fact that @Anonymous has said nothing about it has to be a tacit admission that my post makes a good point.
These infection-associated diseases like post-Lyme and ME/CFS have been neglected by medicine for decades. It was a widespread view that they are actually functional or psychosomatic illnesses, and because of that there was barely any research funding for developing treatments. But that's changing in a big way because of the covid pandemic. Long covid is so prevalent that its undeniable just on an anecdotal level that covid is physically damaging people's bodies leading to chronic illness. The situation with long covid really discredits the FND paradigm because it shows how a disease was ignored for so long because doctors thought people were just mental.
In an alternate universe its not hard to imagine this happening for diabetes. If diabetes were be controversial much like LC and ME today. Someone going to the doctor would hear "dont believe what you read online about diabetes, you can eat whatever you want, your blood sugar is fine and theres no need to inject yourself with insulin. We're going to give you CBT so you can move past your fixed beliefs about insulin resistance". A person following that advice would soon go into diabetic shock and could easily die. The only difference between the diabetes example and diseases like LC, ME, hEDL, POTS, etc is that those are much less well understood by medicine with much less awareness. FND (and Function Cognitive Disorder, the subtype I was misdiagnosed with) are diagnoses of exclusion, as we can see in this paper (see box 2, it says "Symptoms or deficit that are not better explained by another medical or psychiatric disorder."). So when you have other medical diagnoses which are poorly understood, from the point of view of a doctor these other diagnoses wont explain the symptoms, because they dont know much about them. And from that its easy to see why these people are often misdiagnosed, sometimes with catastrophic results.Neurologists falsely diagnosing people with Functional Neurological Disorder (FND) really matters. It destroys peoples lives. I was diagnosed by a neurologist with Conversion Disorder (what FND was known as before they changed the name).
Dr.T, PhD (@chydorina) February 21, 2026
I believed him and spent the next few... https://t.co/RxLaKjnjFz
You didnt mention that Functional Cognitive Disorder has no evidence-based treatments.
eg https://pmc.ncbi.nlm.nih.gov/articles/PMC7850207/
also https://pubmed.ncbi.nlm.nih.gov/37775194/
The fact that FCD has no evidence-based treatments is all the more reason to be absolutely sure that the diagnosis is correct. If an alternate diagnosis turns out to be right you'll be very happy if that has effective evidence-based treatments (eg POTS which I suggested)