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Health condition · Clinically reviewed

Conversion disorder, now called functional neurological disorder (FND).

Real neurological symptoms, a positive diagnosis on examination, and multidisciplinary rehabilitation that can genuinely improve them.

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Why trust this guide

  • 01

    Clinically reviewed

    Written by our editorial team and reviewed by a registered UK clinician before publication.

  • 02

    Sourced from guidance

    Cross-checked against DSM-5-TR, ICD-11, FND Society consensus and Neurosymptoms.org.

  • 03

    Current for 2026

    Reflects modern UK practice, including positive clinical signs, specialist FND clinics and multidisciplinary rehabilitation.

Key facts

Conversion disorder and FND at a glance.

The essentials, in plain English. What FND is, how common it is, how it is diagnosed and how it is treated in the UK today.

  • What it is

    Functional neurological disorder (FND), previously called conversion disorder. Real neurological symptoms that are not fully explained by structural neurological disease.

  • How common

    Very common in neurology, accounting for up to 15 to 30 per cent of new outpatient referrals. Roughly twice as common in women.

  • Positive diagnosis

    Diagnosed on positive clinical signs like Hoover sign and tremor entrainment, not by ruling everything else out.

  • Main presentations

    Functional seizures, functional limb weakness, functional movement disorders, sensory symptoms, speech, vision and functional cognitive symptoms.

  • Cause

    A biopsychosocial brain network problem, often triggered by injury, illness or surgery. It is not faking and not made up.

  • Treatment

    Specialist FND clinics, FND-trained physiotherapy, occupational therapy, speech therapy, CBT and, where relevant, trauma-focused therapy.

Why this guide matters

A real diagnosis, with real treatment.

FND has been misunderstood for decades. Modern neurology approaches it as a genuine brain network condition with positive signs and effective treatment.

  • A positive diagnosis

    FND is diagnosed on what is present on examination, like Hoover sign and tremor entrainment, not by ruling everything else out.

  • Not imagined, not faked

    Symptoms are real. FND is a problem with how brain networks control movement, sensation and attention. It is not under conscious control.

  • Recovery is possible

    With FND-specialist physiotherapy, occupational therapy, CBT and, where relevant, trauma-focused therapy, symptoms often improve significantly.

How the diagnosis is made

From first symptoms to a specialist plan.

The steps a UK neurologist and multidisciplinary team will normally follow, so you know what to expect at each stage.

  1. 01

    Assessing

    History and timeline

    A careful history of onset, triggers, symptom variability and any physical or emotional precipitant like injury, illness or surgery.

  2. 02

    Assessing

    Positive clinical signs

    Hoover sign, hip abductor sign, tremor entrainment, distractibility, drift without pronation. These are the key features, not the absence of other disease.

  3. 03

    Assessing

    Screen for comorbidities

    Anxiety, depression, PTSD, chronic pain, fibromyalgia, fatigue, POTS, migraine and IBS often travel alongside FND.

  4. 04

    Confirming

    MRI brain and structural imaging

    Usually normal in FND. Used to rule out stroke, MS, tumour and other structural causes when the picture is unclear.

  5. 05

    Confirming

    Video-EEG for functional seizures

    The gold standard when seizures are suspected. Captures a typical event and shows no epileptiform activity.

  6. 06

    Confirming

    Neurology and psychiatry review

    Assessment by a neurologist experienced in FND, often alongside a neuropsychiatrist for comorbid mental health needs.

  7. 07

    Preparing

    Referral to a specialist FND service

    Multidisciplinary FND clinics in Edinburgh, London, Liverpool, Bath, Sheffield and Newcastle coordinate rehabilitation and therapy.

Typical pathway: neurology assessment, targeted tests, then a specialist FND service to lead treatment.

Symptoms

What FND actually looks like.

FND can affect movement, sensation, seizures, speech, vision or cognition, sometimes in combination. Patterns are recognisable to an experienced clinician.

  • Functional seizures

    Resemble epilepsy but with no epileptiform EEG. Often longer, with pelvic thrusting, side-to-side head movement, tightly closed eyes and sometimes preserved awareness.

  • Functional limb weakness

    Variable and inconsistent weakness with positive Hoover sign, collapsing pattern or hip abductor sign on examination.

  • Functional movement disorders

    Tremor with entrainment and distractibility, fixed dystonic postures, tics, myoclonus or a distinctive astasia-abasia gait.

  • Sensory symptoms

    Numbness or altered sensation in a non-anatomical distribution, with midline splitting and inconsistent findings on repeat testing.

  • Functional speech

    Mutism, slow and effortful speech, stuttering or a foreign accent syndrome that varies with context.

  • Visual symptoms

    Tunnel vision, non-organic blindness or blurring that does not match a structural or ophthalmological cause.

  • Functional cognitive symptoms

    Brain fog, subjective memory and attention problems with normal performance on formal cognitive testing.

  • Red flag mimics

    New focal weakness, sudden severe headache, fever, progressive deficit or first-ever seizure needs urgent review to exclude stroke, infection or epilepsy.

Treatment

How FND is treated in the UK.

A clear positive diagnosis and explanation come first, followed by multidisciplinary rehabilitation and, where needed, psychological therapy.

  • Positive diagnosis and explanation

    The single most important intervention. A clear, validating explanation that FND is a brain software problem, not a hardware one, and not imagined.

  • Specialist FND clinic

    Multidisciplinary care in Edinburgh, London (Queen Square, King’s), Liverpool, Bath, Sheffield or Newcastle coordinates the whole plan.

  • FND-trained physiotherapy

    Specialist motor retraining and movement-based rehabilitation, not general strengthening. Evidence-based and often the backbone of recovery.

  • Occupational therapy

    Practical work on daily activities, energy management, pacing and staged return to home, study or work.

  • Speech and language therapy

    Targeted therapy for functional speech, voice and swallowing symptoms, delivered by clinicians familiar with FND.

  • Cognitive behavioural therapy (CBT)

    Evidence-based talking therapy, especially useful for functional seizures, anxiety, low mood and unhelpful symptom cycles.

  • Trauma-focused therapy and EMDR

    For people with a clear trauma history or PTSD alongside FND. Delivered by trained trauma therapists.

  • Inpatient rehabilitation

    Intensive multidisciplinary programmes for severe or complex FND when outpatient care has not been enough.

Medication

Not a cure, but often useful for comorbidities.

SSRIs, SNRIs, amitriptyline or gabapentin can help comorbid depression, anxiety, chronic pain or migraine. Where functional seizures have been misdiagnosed as epilepsy, antiepileptic medication is gradually withdrawn under specialist supervision, alongside psychological therapy and a safety plan.

What this guide is based on

The sources behind every claim on this page.

International diagnostic manuals, specialist FND consensus and trusted patient resources, current at the time of last review.

Key references

Guidelines and standards we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your neurologist, GP or specialist FND team know your history and examination and can tell you which parts apply to you.

  • DSM-5-TR. Functional Neurological Symptom Disorder (Conversion Disorder).

  • ICD-11. Dissociative neurological symptom disorder.

  • Stone J and colleagues. Neurosymptoms.org, patient-facing information on FND.

  • FND Society and FND Hope UK. Guidance and patient support resources.

  • Espay AJ and colleagues. Current concepts in diagnosis and management of functional neurological disorders, JAMA Neurology.

Red flags

When neurological symptoms need urgent attention.

Some symptoms need same-day or emergency assessment, whatever the eventual diagnosis. If in doubt, call 111, contact your GP urgently, or dial 999.

  • New focal weakness or facial droop

    Any suggestion of stroke, especially sudden onset, needs 999 and immediate emergency assessment.

  • First-ever seizure

    A first seizure of any kind needs urgent neurology assessment, not a functional label from the start.

  • Sudden severe headache

    Thunderclap headache, worst-ever headache or headache with fever needs immediate review to rule out bleed or infection.

  • Progressive deficit

    Steadily worsening weakness, sensory loss or coordination should prompt repeat neurology assessment for a structural cause.

  • Suicidal thoughts or crisis

    FND commonly overlaps with depression, PTSD and anxiety. Suicidal thoughts need urgent GP, crisis team or 999 contact.

  • Injury from falls or seizures

    Any head injury, fracture or serious injury after a fall or functional seizure needs A&E assessment on the day.

  • New bladder or bowel loss

    Cauda equina and spinal cord causes must be excluded urgently in anyone with new weakness and sphincter symptoms.

  • Rapidly changing cognition

    Sudden confusion, marked drowsiness or fluctuating consciousness needs urgent medical review, not a functional label.

  • Signs of misdiagnosed epilepsy

    If seizures are not responding to antiepileptics, or the pattern is atypical, ask for video-EEG at a specialist centre.

Living with it

A treatable condition, with a clear path forward.

Understanding FND, engaging with specialist therapy, pacing sensibly and planning a supported return to activity make the biggest day-to-day difference.

A quiet reminder

Longer duration and greater severity are harder, but not hopeless.

Prognosis in FND is variable. Many people improve significantly with the right team, especially when treatment starts early and is consistent.

  1. 01 Understand

    Learn about FND

    Neurosymptoms.org, FND Hope UK and the FND Society explain the science clearly. Understanding the condition is part of the treatment.

  2. 02 Rehab

    Stick with therapy

    FND-trained physiotherapy, occupational therapy and CBT work best when done consistently over months, not weeks.

  3. 03 Pacing

    Pace, do not push through

    Boom-and-bust makes FND worse. Steady activity, planned rest and gentle graded return are more effective than heroic bursts.

  4. 04 Work

    Plan a supported return

    Access to Work, reasonable adjustments and a phased return, guided by occupational therapy, protect recovery and confidence.

Frequently asked

Everything we get asked about conversion disorder and FND.

Quick answers on diagnosis, causes, treatment and UK services.

  • What is conversion disorder or FND?

    Functional neurological disorder (FND), also called conversion disorder in DSM-5-TR and dissociative neurological symptom disorder in ICD-11, describes real neurological symptoms such as weakness, seizures, tremor, sensory change or speech problems that are not fully explained by structural neurological disease. It is a problem with how brain networks work, not with brain structure.

  • Is FND the same as saying it is all in my head?

    No. FND is a genuine neurological condition. Symptoms are not faked, imagined or under conscious control. The brain networks that generate movement, sensation and attention are not working as they should, and that can be measured and treated.

  • How is FND diagnosed?

    By a neurologist, using positive clinical signs on examination such as Hoover sign, hip abductor sign and tremor entrainment. Imaging like MRI and tests like video-EEG are usually used to rule out other conditions rather than to make the FND diagnosis itself.

  • What causes FND?

    FND is best understood as a biopsychosocial condition. Physical triggers like injury, illness or surgery are common, and stress or past trauma can also play a role. Many people have no clear single trigger, and the diagnosis does not depend on finding one.

  • Can FND be treated?

    Yes. Specialist FND clinics, FND-trained physiotherapy, occupational therapy, speech therapy and psychological therapies including CBT and, where relevant, trauma-focused work can significantly improve symptoms. Outcomes are best when treatment starts early and is multidisciplinary.

  • Where can I get help in the UK?

    The NHS has specialist FND services in centres including Edinburgh, London (Queen Square and King’s), Liverpool, Bath, Sheffield and Newcastle. Neurosymptoms.org, FND Hope UK, the FND Society and FND Action are trusted resources for education and peer support.

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