One moment, you can walk independently, hold a conversation or complete everyday activities. A few hours later, you may experience weakness, tremors, overwhelming fatigue, difficulty speaking or problems with mobility.

How can someone's neurological symptoms change so dramatically within the same day?

In Episode 9 of FND: The Questions Nobody Asks, Paul Edwards explores one of the most misunderstood aspects of Functional Neurological Disorder (FND): fluctuating neurological symptoms.

For many people living with FND, good days and bad days are not always predictable. Symptoms can vary throughout the day, sometimes without an identifiable trigger.

In this episode, we explore:

• Why FND symptoms can fluctuate from hour to hour.
• How someone may walk independently one moment but require mobility assistance later.
• Why fatigue, physical exertion, illness and other factors may influence symptoms.
• Why symptoms can worsen without someone feeling anxious or stressed.
• The impact of fluctuating symptoms on everyday activities, employment and independence.
• Why a short medical appointment may not reflect someone's difficulties throughout the week.
• The importance of understanding fluctuating disability during healthcare and social care assessments.
• How individualised rehabilitation, specialist physiotherapy, occupational therapy and symptom management may help.
• Why new or significantly changing symptoms still require appropriate medical assessment.

A Good Day Does Not Mean Someone Has Recovered

One of the greatest challenges for people living with FND is being misunderstood when their symptoms change.

Someone may walk into a supermarket but struggle to walk back out.

They may communicate clearly during a medical appointment but experience speech difficulties later.

They may enjoy an afternoon with friends and subsequently require significant rest or assistance.

These fluctuations do not mean someone is pretending, exaggerating or choosing when to experience symptoms.

FND symptoms are genuine and involuntary.

Understanding this is particularly important for families, employers, healthcare professionals and social care assessors.

A person's abilities during a single appointment may not accurately represent their needs throughout an entire day or week.

Understanding the Invisible Challenges

Living with unpredictable neurological symptoms can affect confidence, relationships, education, employment and independence.

Making plans can become difficult when someone cannot reliably predict how they will feel later.

Greater awareness means recognising that disability is not always constant or visible.

"Seeing someone walk today does not mean they could walk yesterday. Seeing someone smile does not mean they are not struggling."

About the Presenter

Paul Edwards lives with Functional Neurological Disorder and functional aphonia, which affects his ability to speak.

Although this podcast uses computer-generated narration, the words, research and lived experiences shared are his own.

Through FND: The Questions Nobody Asks, Paul aims to challenge misconceptions, promote evidence-informed education and improve understanding among patients, families, carers, healthcare professionals and the wider public.

Because understanding begins when we stop making assumptions.

Further Information

For evidence-informed information about FND and neurological rehabilitation:

NHS inform: https://www.nhsinform.scot

FND Guide: https://www.neurosymptoms.org

NICE Guidance: https://www.nice.org.uk

Medical Disclaimer: This podcast is intended for educational and awareness purposes only. It does not replace professional medical advice, diagnosis or treatment. New, sudden, unfamiliar or significantly changing neurological symptoms should receive appropriate medical assessment.

Functional Neurological Disorder (FND) is often associated with adults, but did you know that children, teenagers and young adults can also develop this complex neurological condition?

In Episode 8, Paul Edwards explores the realities of FND in younger people, the challenges they face and why greater awareness is urgently needed across England, Wales, Scotland and Northern Ireland.

Imagine being fourteen years old, watching your friends attend school, enjoy sports and make plans for their futures, while you struggle with weakness, tremors, functional seizures, fatigue or difficulties walking.

For some young people living with FND, this is their everyday reality.

In this episode, we explore:

• How FND can affect children, teenagers and young adults.
• Why functional neurological symptoms are genuine and involuntary.
• Why normal medical investigations do not mean symptoms are imaginary.
• The importance of appropriate diagnosis and early recognition.
• How FND can affect education, friendships, independence and emotional wellbeing.
• Educational support arrangements across the four UK nations, including EHCPs in England, Individual Development Plans in Wales and Additional Support for Learning in Scotland.
• The importance of coordinated healthcare, rehabilitation and school support.
• Challenges when transitioning from children's to adult healthcare services.
• Why parents, carers, teachers and healthcare professionals need greater FND awareness.

More Awareness. Brighter Futures.

Children living with FND deserve to be listened to, believed and supported.

Their symptoms should never automatically be dismissed as attention-seeking, behavioural difficulties or school avoidance.

Equally, an FND diagnosis should be made through appropriate clinical assessment, and new or changing symptoms should not automatically be attributed to FND.

This episode also explores something that can be overlooked: loneliness.

For a young person, losing contact with school friends, missing important milestones or feeling different from their classmates can be deeply isolating.

Sometimes, what a child wants most is simply one friend who understands.

Greater awareness must extend beyond hospitals and clinics into schools, youth organisations, families and communities.

A child with FND is still a child. They deserve an education, friendships, understanding and the chance to enjoy growing up.

About the Presenter

Paul Edwards lives with Functional Neurological Disorder and functional aphonia, which affects his ability to speak.

Although this podcast uses computer-generated narration, the research, words and lived experiences shared are his own.

Through FND: The Questions Nobody Asks, Paul aims to challenge misconceptions, promote evidence-informed education and encourage greater understanding of FND.

Because understanding begins when we stop making assumptions.

Further Information and Resources

• NICE — Neurological Rehabilitation Guidance (NG252)
• NICE — Suspected Neurological Conditions in Children (NG127)
• NHS Scotland — Functional Neurological Disorder Pathway
• GOV.UK — Special Educational Needs and EHCPs
• Welsh Government — Additional Learning Needs
• Education Scotland — Additional Support for Learning
• Northern Ireland Department of Education — Special Educational Needs

Medical Disclaimer: This podcast is intended for educational and awareness purposes only. It does not replace professional medical advice, diagnosis or treatment. Children and young people experiencing neurological symptoms should receive appropriate assessment from qualified healthcare professionals.