Newly diagnosed and first 72 hours

Understand what the diagnosis means and prepare the next conversation.

First: your symptoms are real

FND symptoms are real and involuntary. A good diagnosis uses recognised positive signs from your history or examination—not simply normal tests or the absence of another answer.

What to do next: Ask which symptoms the clinician believes FND explains and what positive features supported that conclusion.

Important limit: The diagnosis may apply to some symptoms and not others.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

WHO ICD-11 CDDR — World Health Organization. Clinical descriptions and diagnostic requirements for ICD-11 mental, behavioural and neurodevelopmental disorders. Geneva: WHO; 2024.
Diagnosis and management of FND — Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;376:o64.
Practical review for physicians — Bennett K, Diamond C, Hoeritzauer I, et al. A practical review of functional neurological disorder for the general physician. Clin Med (Lond). 2021;21(1):28-36.
Current concepts — Espay AJ, Aybek S, Carson A, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol. 2018;75(9):1132-1141.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
ILAE staged diagnostic certainty — LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach. Epilepsia. 2013;54(11):2005-2018.

Last checked: 2026-07-16

Jurisdiction: UK

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Correction route: Report changed or inaccurate information without including personal health information.

What to write down, if you can

A few notes can make the next appointment easier. This does not need to be complete or written in medical language.

Local preparation: selections and notes stay only in this open page. This site does not save or send them.

Work through the five things at your own pace

The exact diagnosis or term used What I know or need to ask
Which symptoms or event types the diagnosis is meant to explain What I know or need to ask
The positive signs or evidence the clinician found What I know or need to ask
What each test was looking for and what remains uncertain What I know or need to ask
Who owns follow-up, referrals and the next action What I know or need to ask

When ready, use your browser’s print command to print or save this page.

What to do next: Write down what you know and turn anything missing into a question.

Important limit: Leave a gap rather than guessing a diagnosis, test result or referral.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

ILAE staged diagnostic certainty — LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach. Epilepsia. 2013;54(11):2005-2018.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
Motor and sensory FND lived experience — Bailey C, Tamasauskas A, Bradley-Westguard A, et al. What are the experiences of people with motor and sensory FND? A systematic review and thematic synthesis of qualitative studies. Disabil Rehabil. 2025;47(1):1-15.
Diagnosis and management of FND — Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;376:o64.
AAN functional-seizure guideline — Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106:e214466.
NICE NG217 epilepsy diagnosis — National Institute for Health and Care Excellence. Epilepsies in children, young people and adults: diagnosis and assessment (NG217). Updated 30 January 2025.
NICE FND quality statement — National Institute for Health and Care Excellence. Quality statement 5: Functional neurological disorders in adults (QS198). 2021.
NHS England FND minimum services — NHS England. Annex A: Specialised Neurology Service Specification—Minimum Services for Neurology Subspecialties. August 2025.
Scotland FND pathway — NHS Scotland Centre for Sustainable Delivery. Functional Neurological Disorder pathway. Current at 14 July 2026.
Wales FND national optimal pathway — NHS Wales Performance and Improvement, Neurological Conditions Network. National Optimal Pathway for Functional Neurological Disorder: adults aged 16 and over. March 2026.
Journey to diagnosis and care — Pritomanova S, et al. The journey to diagnosis and care of functional neurological disorder. PLoS One. 2026;21:e0328321.
NHS patient-experience service evaluation — O'Keeffe S, Chowdhury I, Sinanaj A, et al. A service evaluation of the experiences of patients with functional neurological disorders within the NHS. Front Neurol. 2021;12:656466.

What normal tests do and do not mean

Tests answer particular questions. MRI and CT look for structural explanations; a normal scan does not by itself prove FND. A normal routine EEG does not exclude epilepsy. A useful results conversation explains what was tested, what was found, what the result cannot rule out and what happens next.

What to do next: Ask: What question was this test meant to answer?

Important limit: There is no universal set of tests for every person or every FND presentation.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

NICE NG217 epilepsy diagnosis — National Institute for Health and Care Excellence. Epilepsies in children, young people and adults: diagnosis and assessment (NG217). Updated 30 January 2025.
Diagnosis and management of FND — Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;376:o64.
Practical review for physicians — Bennett K, Diamond C, Hoeritzauer I, et al. A practical review of functional neurological disorder for the general physician. Clin Med (Lond). 2021;21(1):28-36.
Positive-sign accuracy review — Patwal R, Jolly AJ, Kumar A, Yadav R, Desai G, Thippeswamy H. Diagnostic accuracy of clinical signs and investigations for functional weakness, sensory and movement disorders: a systematic review. J Psychosom Res. 2023;168:111196.
Motor and sensory FND lived experience — Bailey C, Tamasauskas A, Bradley-Westguard A, et al. What are the experiences of people with motor and sensory FND? A systematic review and thematic synthesis of qualitative studies. Disabil Rehabil. 2025;47(1):1-15.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
Practical management review — Dworetzky BA, Baslet G. Functional neurological disorder: practical management. Neurotherapeutics. 2025;22:e00612.

What FND does not say about you

An FND diagnosis does not mean the symptoms are made up. It does not require stress or trauma, and it does not rule out another condition.

Stress, trauma, anxiety or depression is not required for an FND diagnosis.
FND can happen alongside epilepsy, migraine and other neurological or medical conditions.
Different symptoms or event types may need to be described and assessed separately.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

Diagnosis and management of FND — Aybek S, Perez DL. Diagnosis and management of functional neurological disorder. BMJ. 2022;376:o64.
Current concepts — Espay AJ, Aybek S, Carson A, et al. Current concepts in diagnosis and treatment of functional neurological disorders. JAMA Neurol. 2018;75(9):1132-1141.
Practical review for physicians — Bennett K, Diamond C, Hoeritzauer I, et al. A practical review of functional neurological disorder for the general physician. Clin Med (Lond). 2021;21(1):28-36.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
FND subtypes and shared mechanisms — Hallett M, Aybek S, Dworetzky BA, McWhirter L, Staab JP, Stone J. Functional neurological disorder: new subtypes and shared mechanisms. Lancet Neurol. 2022;21(6):537-550.
Cautionary diagnostic notes — Perez DL, Aybek S, Popkirov S, et al. Cautionary notes on diagnosing functional neurologic disorder as a neurologist-in-training. Neurol Clin Pract. 2021;11(1):e72-e76.
Epilepsy and functional seizures coexist — Kutlubaev MA, Xu Y, Hackett ML, Stone J. Dual diagnosis of epilepsy and psychogenic nonepileptic seizures: systematic review and meta-analysis. Epilepsy Behav. 2018;89:70-78.
Functional gait sign-based approach — Nonnekes J, Ruzicka E, Serranova T, Reich SG, Bloem BR, Hallett M. Functional gait disorders: a sign-based approach. Neurology. 2020;94(24):1093-1099.
Migraine and FND overlap — Stone J, Coebergh JA, Khoja L, et al. Migraine and functional neurological disorder: a review of comorbidity and potential overlap. Brain Commun. 2025;7(4):fcaf288.
Practical management review — Dworetzky BA, Baslet G. Functional neurological disorder: practical management. Neurotherapeutics. 2025;22:e00612.
AAN functional-seizure guideline — Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106:e214466.
Functional-seizure mimics — Dudley P, Marquez JP, Farrell F, et al. Functional seizures and their mimics: a retrospective service review of cases from a tertiary video telemetry database. BMJ Neurol Open. 2024;6:e000738.

Questions worth taking to an appointment

Choose only the questions that matter to you; a one-page list is easier to use than a long script.

Local preparation: selections and notes stay only in this open page. This site does not save or send them.

Choose up to three questions to take with you

Which of my symptoms does this diagnosis explain?
What positive signs did you find?
How confident are you about each symptom or event type?
What did each test show—and what did it not show?
Could another condition coexist?
Who is responsible for follow-up and referrals?
What new or changed symptoms should be reassessed?

When ready, use your browser’s print command to print or save this page.

What to do next: Select up to three priorities for the beginning of the appointment.

Important limit: The question builder does not recommend tests or treatment.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

ILAE staged diagnostic certainty — LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach. Epilepsia. 2013;54(11):2005-2018.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
Motor and sensory FND lived experience — Bailey C, Tamasauskas A, Bradley-Westguard A, et al. What are the experiences of people with motor and sensory FND? A systematic review and thematic synthesis of qualitative studies. Disabil Rehabil. 2025;47(1):1-15.
AAN functional-seizure guideline — Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106:e214466.
NICE FND quality statement — National Institute for Health and Care Excellence. Quality statement 5: Functional neurological disorders in adults (QS198). 2021.
NICE NG217 epilepsy diagnosis — National Institute for Health and Care Excellence. Epilepsies in children, young people and adults: diagnosis and assessment (NG217). Updated 30 January 2025.

When it is reasonable to ask again

New, clearly changed or medically worrying symptoms should be checked. Asking for another explanation or a second opinion can also be reasonable when the diagnosis was unclear, positive signs were not explained or an important event type was not assessed.

What to do next: Describe what is new or different instead of relying only on the existing FND label.

Important limit: This page cannot decide whether a change is FND or something else.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

NICE NG127 referral — National Institute for Health and Care Excellence. Suspected neurological conditions: recognition and referral (NG127). Updated 2 October 2023.
NICE FND quality statement — National Institute for Health and Care Excellence. Quality statement 5: Functional neurological disorders in adults (QS198). 2021.
Misdiagnosis in both directions — Walzl D, Carson AJ, Stone J. The misdiagnosis of functional disorders as other neurological conditions. J Neurol. 2019;266(8):2018-2026.
Cautionary diagnostic notes — Perez DL, Aybek S, Popkirov S, et al. Cautionary notes on diagnosing functional neurologic disorder as a neurologist-in-training. Neurol Clin Pract. 2021;11(1):e72-e76.
AAN functional-seizure guideline — Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106:e214466.
ILAE staged diagnostic certainty — LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach. Epilepsia. 2013;54(11):2005-2018.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
NICE NG217 epilepsy diagnosis — National Institute for Health and Care Excellence. Epilepsies in children, young people and adults: diagnosis and assessment (NG217). Updated 30 January 2025.

Where to go next

For medical detail, choose an official or clinician-written explanation. For practical and emotional support, a charity may be the better next step.

information-or-support-resource

NHS Inform Scotland FND (external site)

Explains FND, symptoms, diagnosis, contributing factors, treatment and support

Who it may help: Public; Scotland context but much clinical information is broader
Coverage: Scotland / online
Source check: V1 - public information checked · 2026-07-14

Limit: Overview, not individual diagnosis, referral or treatment plan

information-or-support-resource

Neurosymptoms (external site)

Large plain-language FND library with multiple symptom routes

Who it may help: People with FND, supporters and clinicians
Coverage: International / online
Source check: V1 - public information checked · 2026-07-14

Limit: Information alone is not clinical care; user must identify relevant pages

information-or-support-resource

FND Action - Beyond Diagnosis (external site)

Calm next-step and communication framing

Who it may help: People newly diagnosed and supporters
Coverage: UK / online
Source check: V1 - public information checked · 2026-07-14

Limit: Charity information, not diagnosis or treatment access

What to do next: Choose one useful resource now. You do not need to read everything.

Important limit: Information is useful, but it does not replace treatment, rehabilitation, follow-up or a fresh assessment when one is needed.

Sources and review information

Status: Owner released - source checked

Evidence check: Mapped to checked master-register claims

Jurisdiction: UK

Last checked: Check the linked live source

Prepared by: Project editorial team

Owner release date: 2026-07-22

Independent review: Not independently reviewed

Corrections: Use the site correction route without including personal health information.

Motor and sensory FND lived experience — Bailey C, Tamasauskas A, Bradley-Westguard A, et al. What are the experiences of people with motor and sensory FND? A systematic review and thematic synthesis of qualitative studies. Disabil Rehabil. 2025;47(1):1-15.
Explanation as treatment — Stone J, Carson A, Hallett M. Explanation as treatment for functional neurologic disorders. Handb Clin Neurol. 2016;139:543-553.
Scotland FND pathway — NHS Scotland Centre for Sustainable Delivery. Functional Neurological Disorder pathway. Current at 14 July 2026.
FND Action Beyond Diagnosis — FND Action. FND - Beyond Diagnosis. Accessed 14 July 2026.
FND Action online support groups — FND Action. Online support groups. Accessed 14 July 2026.
FND Hope UK peer groups — FND Hope UK. UK FND Peer Support Groups. Accessed 14 July 2026.
FND Hope UK support services — FND Hope UK. UK support services. Accessed 14 July 2026.
The Brain Charity FND support — The Brain Charity. Functional Neurological Disorder. Accessed 14 July 2026.
PIF TICK quality criteria — Patient Information Forum. PIF TICK criteria at a glance. Reviewed October 2024.
Open Referral UK standard — Government Digital Service. Record and share information about public services in local authorities: Open Referral UK. Updated 29 January 2026.