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Email: asim@rubiconprivatehealth.co.uk

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Understanding FND

Functional Neurological Disorder (FND)

A careful, physiology-informed approach to a complex conditio

Functional Neurological Disorder (FND) is a real, debilitating condition that occurs when the brain’s functional pathways are disrupted despite normal structural scans. Patients may experience a wide range of neurological symptoms, including episodes that resemble seizures, weakness, tremors, sensory disturbances, gait problems or dissociative events.

FND can be frightening and life-altering, especially when patients are told, “Your scan is normal, so nothing is wrong.” Normal imaging does not mean the symptoms are imagined. It means the cause lies in the function of the system rather than its structure.

FND can be frightening and life-altering, especially when patients are told, “Your scan is normal, so nothing is wrong.” Normal imaging does not mean the symptoms are imagined. It means the cause lies in the function of the system rather than its structure.

Identifying the Root Cause

Our Clinical Approach: Evidence-Backed, Mechanism-Focused

The NICE position on FND is clear: FND is a positive diagnosis, not a diagnosis of exclusion.

However, in practice many patients with FND-like symptoms also have treatable medical contributors that can worsen or mimic functional symptoms. These are often overlooked in routine workups.

We assess patients with FND-type presentations using a careful, physiology-based framework, which may include
  • icon Detailed neurological history
  • icon Assessment of autonomic symptoms
  • icon Review of precipitating stressors or triggers
  • icon Evaluation for sleep disorders
  • icon Targeted blood tests where clinically indicated
  • icon Review of metabolic factors that can influence nerve and brain function
The goal is:
  • icon Understand the pattern
  • icon Identify treatable contributors
  • icon Improve symptoms
  • icon Restore function
  • icon Provide a clear explanation and plan

Metabolic Factors and
FND Symptom

Many patients with FND-like symptoms also report:

  • icon Sensory disturbances
  • icon Weakness or collapses
  • icon Dissociative episodes
  • icon Tremors or internal shaking/vibrations
  • icon Cognitive fog
  • icon Fatigue
  • icon Temperature or autonomic instability

Some of these symptoms can overlap with those seen in vitamin deficiencies (such as B12, D or iron) or other metabolic issues.

We do not claim these deficiencies cause FND. But we do recognise that metabolic issues can exacerbate symptoms or create parallel neurological disturbances that complicate the picture.

Our role is to identify and treat what is treatable. This aligns with both clinical reasoning and patient safety.

Clinical Experience & Ongoing
Case Work

We have cared for several patients with FND-type presentations who improved significantly after a combination of:

  • icon Careful neurological assessment
  • icon Metabolic optimisation
  • icon Structured follow-up
  • icon Tailored symptom-management strategies

Some cases have shown notable improvement after treating deficiencies such as B12, vitamin D or iron — particularly where symptoms overlapped with metabolic or autonomic dysfunction.

We are currently developing case studies and observational reports in this area, with the intention of contributing to the broader clinical understanding of FND.

This research-engaged approach ensures we practise responsibly, transparently, and with academic credibility.

What You Can Expect From Us

1. A respectful, validating approach
Your symptoms are real and not dismissed as “psychological”.

2. A careful neurological and systemic review
We examine symptoms, timelines, triggers and patterns.

3. Investigation of treatable contributors
Where clinically appropriate.

4. Supportive management plan
Covering movement, pacing, metabolic health, sleep, stress physiology, and functional neurology principles.

5. Honest communication about prognosis
FND recovery is variable. Many improve significantly. Some improve partially and recovery may take some time. A cautious but hopeful prognosis is always safest and most accurate.

6. Ongoing follow-up and monitoring
We do not discharge you after a single consultation.

Why Patients Choose Rubicon Private
Health for FND-Like Symptoms

  • icon A GP with deep experience in complex neurological presentations
  • icon Non-judgemental, thorough care
  • icon Longer appointments
  • icon Clinical curiosity rather than dismissal
  • icon Recognition of metabolic contributors that are often overlooked
  • icon A research-engaged, evolving approach
  • icon Clear communication + logical explanations

Many patients come to us after years of feeling unheard. We aim to change that experience.

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