COVID-19 restrictions to remain in place at The Walton Centre

Restrictions remain in place across the NHS in relation to the COVID-19 pandemic. The safety measures in place over the 18 months therefore remain in place at The Walton Centre - and in our other clinic settings within the community – until further notice.

Due to the increased transmission risk posed by the Omicron variant, visiting has been suspended within The Walton Centre except for exceptional circumstances.

Functional Motor Disorder

What is functional motor disorder?

It is a common condition where people experience abnormalities of control of movement, for example weakness of limbs, walking difficulties, tremors, jerks or abnormal posture of the limbs. There is a very specific problem with how the brain is working. The ‘basic wiring’ of the nervous system is intact and can work. There is no problem with motivation or will to move normally. Instead, the problem lies in the person’s ability to control their body. The messages cannot get through in a normal way. The symptoms are real and are not ‘put on’ or ‘all in the mind’. Functional motor disorder (FMD) is part of a wider group of conditions called ‘Functional Neurological Disorder’ (FND).

How many people have FMD?

Not many people have heard of FMD and it can be misunderstood by health professionals and the public. This might make you think it is rare. However, it is one of the most common reasons for someone to see a neurologist.

What causes FMD?

It’s a complex question. And one that medical science is learning more about every year. What we do know is that there is probably not one single cause and everyone is different. However, there is one important feature of what goes wrong in FMD. That when the persons attention (awareness) is on their body, their symptoms are worse.

Attention and FMD

It is a really important feature of what goes wrong in FMD. By attention we mean where the brains thoughts and awareness is focused (its spotlight). When the persons attention is distracted away from their body, their movement becomes more normal. This can help explain why FMD symptoms can vary over a short period of time.

How is the diagnosis made?

It is usually made by a neurologist or similar specialist doctor. The symptoms of FMD can look very similar to symptoms seen in structural neurological disease (like stroke). But when examined closely they have important differences. It is these differences that tell the neurologist the symptoms are due to FMD. People with FMD have normal scans and other tests (may show signs of normal wear or tear).

Some common signs are:

  • Collapsing weakness – limb gets weaker the more you try.
  • A dragging kind of walk.
  • A difference between power of the limbs on the bed and when walking. Some people can have relatively normal strength in the legs on the bed but weak legs when walking. The reverse can be true.
  • Tremor – one that changes speed. Is sometimes absent.

Will I get better?

Unfortunately there is no quick fix. If recovery was quick and easy you would probably be better by now. However people with FND can recover fully. On the other hand, some people have very persistent and disabling symptoms. Physiotherapy and psychology can help some people.

What can I do to help myself?

It is important to come to terms with the diagnosis of functional symptoms. It is difficult for people to get better if they continue to look for a structural explanation for their symptoms. Talking to friends and family about your symptoms and how you feel can be very helpful.

What happens if my movement problem does not improve?

We think it is most likely you will see some improvement with treatment. However, if the treatment makes no difference, your neurologist may consider alternative treatment options.

Service Leads

Dr Jayne Martlew - Consultant Neuropsychologist

Dr Christine Burness - Consultant Neurologist

Michael Walsh - Specialist Physiotherapist

Tel: 0151 556 3510

Website: www.thewaltoncentre.nhs.uk

Useful Websites:

www.neurosymptoms.org 

www.nonepilepticattacks.info

Charities:

  • FND Hope 
  • FND Action
  • Last Updated:
    01 October 2020
  • Review Date:
    01 October 2022
  • Author:
    Michael Walsh
  • Summary:

    It is a common condition where people experience abnormalities of control of movement, for example weakness of limbs, walking difficulties, tremors, jerks or abnormal posture of the limbs. 

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