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I wish they could be a little more humble. But I think a lot of these people are actually convinced they do know the answer. People become convinced of all sorts of things for bad reasons and it can be very hard to change their minds. Just think about all the terrible explanations that humans...

Yes the hypocrisy is infuriating. It really is a lose-lose situation for everyone but the FND advocates. However, the only way out of this mess is through research and even small steps are a win to me. If we can demonstrate specific abnormalities in FND patients then at least there tangible...

What good timing. This is exactly the kind of research we need to dismantle the FND bandwagon.

I agree that separating ME/CFS from FND is very important. Both for patients and to make sure research doesn't get mixed up and reduce the likelihood of getting useful findings. It is a difficult thing to do with some of these FND practitioners handing out FND diagnosis willy-nilly. Because we...

I am certainly in agreement on that. Any replacement term for FND would inherit the baggage of the prior labels, just like FDN has connotations of conversion disorder. Ultimately the only way to change the mindset of doctors is more research to understand the underlying mechanisms and provide...

There are so many great comments here. I do now think there are a group of patients, who after an extensive workup have certain common issues and still have no clear explanation for their neurological symptoms. It makes sense to label these patients so that do not receive completely unwarranted...

Thanks for explaining, I deleted the comment because I came upon David's blog on it which answered the question for me! For some reason I can still get past the paywall using my university log in even though I graduated years ago. Isn't the specificity claim circular? Don't you have to have a...

In that specific context I understand the use of FND as label. My only pushback is on the implication about causes and on the misuse of that label. I have the same criticism of the people running around saying POTS is an autonomic nervous system issue when we don't know that is the case. My...

If FND refers to a neurological condition with no known cause then I have absolutely no issue with that. It would be like if hEDS only referred to some general hypermobility, then I don't think anyone would have an issue with that either. The problem is FND (as with hEDS) entails more than that...

True but a "subtle shift in brain function" is a useless definition that tells us nothing. Eating a hamburger causes a subtle shift in brain function but that has nothing to do with FND.

I actually see them as very similar. I think FND is based on a scientific error much in the same way as you see hEDS. Just like you think there is little or no evidence that hypermobility in general is an illness, I don't think that a subtle disfunction of the brain's software is an illness. I...

How do we work out probabilities for something we are essentially clueless about? Regardless of whether FDN is a subtle shift in brain function, an issue with the brain's software or a disconnection in the function of the lobes and emotional processing, it has not demonstrated to be a possible...

I don't think Hannah is being conned. She isn't knowing being lied to. However, the truth should matter to her if she actually cares about what is wrong with her fridge and wants to make sure it works correctly. If the technician had come out twiddled a fake knob and did not fix the issue, that...

I will almost certainly take people with FND at their word that their symptoms exist and may be debilitating. If people with FND feel that label is a good description of their condition I also have no problem with that. What I am skeptical exists is that FND is due to a problem with the brain's...

Would that definition not include ME/CFS? I can see how a functional diagnosis might help certain patients who are content with their lives and happy to not take further steps to try and figure out the issue. But to me it feels like giving up. It is accepting that there is a problem that isn't...

Except they don't provide any evidence that this is what is going on. If they had evidence of non structural brain malfunctions they would be more specific and not use a vague term like functional. I think it only helps FND proponents to assume 'functional' changes are occurring just because we...

I do not see a clear distinction between exertion intolerance and PEM. If we are using exertion intolerance to describe a worsening of symptoms post exertion, and not just a decreased capacity to exert, then I think this can match PEM. I have never found the delayed portion of PEM particularly...

How about if in people with POTS the brain vessels do not sufficiently dilate to ensure that blood flow remains stable? I presume there are very many mechanisms to ensure sufficient CBF in healthy individuals when standing. Given that CBF needs to remain within a pretty tight window, it seems...

Could it not be the other way around. Perhaps, when upright, the brain gets less perfusion in people with POTS for whatever reason and so heart rate increases to try and address this. While this might help normalize cerebral flood flow for a little while, eventually it won't be able to keep up...

Does lower body negative pressure have the same physiological effect that being upright does?