When injury changes everything: understanding Functional Neurological Disorder

The moments after an accident can feel suspended in time. One second you’re driving along a familiar road, walking down the stairs at work or taking the escalator at the station and the next you’re dealing with the shock of a fall, the sound of crumpling metal and the disorienting aftermath of forces your body was never meant to withstand.

For most people, the physical injuries become apparent quickly; whiplash, bruising and broken bones, perhaps. But for some, the real challenges emerge in the weeks and months that follow, manifesting in ways that neither they nor their doctors immediately understand. This is often when Functional Neurological Disorder [FND] makes its presence known.

What is Functional Neurological Disorder?

Functional Neurological Disorder is a complex condition, involving problems with how the brain and nervous system send and receive signals, despite conventional medical scans showing no structural damage. It’s also important to recognise that FND can co-exist with other conditions, and the key issue is function, not whether a scan appears normal.

This issue sits at the intersection of neurology and psychiatry. For decades, it was misunderstood and stigmatised, yet today, we know FND is a legitimate neurological condition that is now believed to affect a minimum of 50,000 –100,000 people in the UK.

Symptoms can appear suddenly and progress rapidly. Someone might develop limb weakness or paralysis, experience seizures that aren’t epileptic in nature, struggle with walking or coordination, or suffer from tremors, spasms and sensory issues.

Sufferers might find their speech affected, or experience cognitive symptoms sometimes described as ‘brain fog’, such as difficulty concentrating, memory problems and mental fatigue that makes even simple tasks feel overwhelming.

What makes FND particularly challenging is that these symptoms are real and genuinely disabling, yet they currently don’t show up on traditional MRI scans or blood tests. This can lead to frustration for the person experiencing the symptoms and for medical professionals trying to reach a diagnosis.

Research studies show differences in brain network activity in individuals with FND and although this isn’t yet something that can be used as a routine diagnostic scan, it confirms what patients have long known: these symptoms are not imagined or fabricated for effect.

The connection between trauma and FND

FND can be triggered after physical injury or illness and it’s also commonly seen after frightening or stressful events, including road traffic accidents. The trauma doesn’t need to be severe, even relatively minor accidents can precipitate the condition in susceptible individuals.

The mechanism appears to involve the brain’s response to the body feeling different after injury, particularly in circumstances of heightened stress and vigilance that naturally follow any serious accident.

A typical scenario might involve a head-on collision at relatively low speed, but the combined impact speeds can be life-changing. The individual sustains whiplash and soft tissue injuries, which although painful, are expected to heal without long-term health impacts. 

However, in the aftermath, they begin experiencing symptoms that seem disproportionate to the physical injuries. Perhaps they develop a tremor that wasn’t there before, or weakness in a limb that has no structural damage.

They might experience non-epileptic seizures or find themselves unable to walk properly despite no identifiable neurological damage. New sudden weakness, facial droop, or first-time seizure symptoms should always be assessed urgently to rule out other causes.

The brain, functioning as a predictive organ, has essentially made incorrect predictions about the body following the trauma. Altered signals about movement and sensation create a feedback loop where symptoms become self-perpetuating.

If someone expects to have continuing symptoms from ‘brain damage’, those expectations can become reality, not through malingering or imagination, but through genuine changes in how the brain processes information.

In Part Two of this series on Functional Neurological Disorder [FND] we will go beyond the illness itself and look at why making a claim against those responsible is complex, but with the right support, good outcomes are more likely.

If you or someone you know has been involved in an accident and are experiencing unexplained neurological symptoms, or if you’ve been diagnosed with FND following an incident that wasn’t your fault, it’s important to seek specialist legal advice. 

At Coodes, we recognise that behind every FND claim is an individual whose life has been profoundly affected by someone else’s negligence. We combine technical legal expertise with genuine compassion to ensure you will be heard, supported and properly represented throughout what can be a lengthy and challenging process.

David Usher is an Associate in the Personal Injury department and advises clients on a wide variety of claims, always striving to achieve the best possible settlement, whether the claim is a straightforward accident with a quick recovery or a more complex and life-changing accident resulting in lifelong injuries.

Please contact him via david.usher@coodes.co.uk or call Coodes on 0800 328 3282.

End of Part One

#1 – https://jnnp.bmj.com/content/96/4/383

Click to view Part Two