Functional neurological disorder
Making a positive diagnosis of functional weakness, movement disorder and dissociative seizures, what DSM-5-TR requires, how to explain it, and the Australian 2025 treatment recommendations.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Genuine, disabling neurological symptoms from a problem of nervous system function, not structure. Patients are not feigning.
- One of the commonest diagnoses in neurology clinics. More common in women, onset usually 20s to 50s, but any age.
- Diagnose on positive signs, not because tests are normal. Misdiagnosis rates are about 4%, similar to other neurological diagnoses (Stone, BMJ 2005).
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Sources
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)American Psychiatric Association, 2022
- Lehn A, Petrie D, Palmer D et al. Managing functional neurological disorder: treatment recommendations for health professionals in Australia. BMJ Neurol Open 2025;7:e000970AU/NZBMJ Neurology Open, 2025
- Functional neurological disorders: an Australian interdisciplinary perspective. Med J Aust 2022;216(10)AU/NZMedical Journal of Australia, 2022
- Nielsen G et al. Specialist physiotherapy for functional motor disorder in England and Scotland (Physio4FMD): a pragmatic, multicentre, phase 3 randomised controlled trial. Lancet Neurol 2024The Lancet Neurology, 2024
- Goldstein LH et al. Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. Lancet Psychiatry 2020;7:491-505The Lancet Psychiatry, 2020
- Stone J et al. Systematic review of misdiagnosis of conversion symptoms and hysteria. BMJ 2005;331:989BMJ, 2005
- Nightscales R, McCartney L, Auvrez C et al. Mortality in patients with psychogenic nonepileptic seizures. Neurology 2020;95(6):e643-e652AU/NZNeurology, 2020
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy