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Home / FAQ / If I already have FND but get new symptoms or a flare up, when should I seek a medical re-evaluation?

If I already have FND but get new symptoms or a flare up, when should I seek a medical re-evaluation?

This is a common question people with FND ask. You may be used to your FND symptoms of limb weakness, tremor or seizures, but then something else comes along that throws you – a new symptom – an unexpected flare-up of old symptoms. At one point should you head back to your doctor to ask if something else is going on?

This question is often clouded by bad experiences that people with FND have had when they have seen their doctor with new symptoms in the past.

“I’m unusually tired” – “That’s just your FND”

“I’ve got new memory symptoms” – “That’s just your FND”

“I’ve got abdominal pain” – “That’s just your FND”

It can often feel like doctors are not taking new problems seriously because of your existing diagnosis, something that has been highlighted in surveys of the experience of people with FND.

This isn’t just an FND issue. People with any long-term condition that could produce different symptoms, like MS, Diabetes and Anxiety also experience this issue – which is sometimes called ‘diagnostic overshadowing’.

So here are some tips to deal with the issue – but PLEASE see your doctor if you have concerns or doubts:

  1. Expect to have relapsing or different symptoms. Not an easy one, but it is true that people with FND ARE more likely to develop other FND symptoms in the future as well as relapses of their existing ones. Ive put together a page on relapses elsewhere on the website.
  2. Is the symptom you have the same as the one you had before – but maybe worse? If that’s the case it is more likely to be part of your original FND.
  3. Try to find a doctor you can trust. Ideally, you can share new symptoms with a doctor you know will look at things with an open mind to help decide if they are part of FND, or perhaps like pain or fatigue issues, common associated symptoms related to another functional disorder.
  4. Learn that FND commonly co-exists with other conditions, and help your doctor to do the same. One of the strongest risk factors for FND is having another neurological condition. So whenever a doctor makes an FND diagnosis, they should be thinking – what else does this person have? It might be migraine, carpal tunnel syndrome or something else. Doctors often assume that people with FND don’t have confidence in the diagnosis, because it has been historically neglected. If you do have confidence in your FND diagnosis, then maybe explain that upfront but point out that you want to make sure nothing else is going on, That’s a very reasonable position to present as a patient seeking help.
  5. Learn which symptoms are potentially part of FND and which are not. There is a lot of confusion out there about what FND is. FND is not chronic pain, fatigue or abdominal symptoms. FND does happen alongside those things a lot, especially when they are caused by conditions like fibromyalgia or irritable bowel syndrome. There is value in seeing how they connect to each other as different types of functional disorders, but also they may have treatments of their own. So doctors should not be calling things FND which aren’t even recognised as part of FND. A reminder too that FND is not diagnosed just because someone has neurological symptoms like weakness, seizure and tremor. They have to have specific clinical features which are typical of the FND diagnosis. See this page for some clarity about which are potentially FND symptoms and which are not.
  6. Is your concern about symptoms ‘over the top’ in a way that even you recognise? It is normal to be concerned by new symptoms, or want to look them up. But if you are constantly seeking reassurance about new or minor symptoms you may have health anxiety. It’s actually not that common but if you find you are spending a lot of time thinking about your symptoms, googling them for hours or having thoughts about how serious they are, which you recognise as being ‘over the top’, then consider whether you may have health anxiety. Health anxiety is a horrible thing to have, not least because people with it find it very hard to talk about it, knowing what other people may think. There’s a page on health anxiety with some resources on it on this website.