Life Expectancy in Functional Neurological Disorder
FND does not shorten life expectancy or cause death—it is not a degenerative or life-threatening condition, and mortality rates are not elevated compared to the general population. 1
Why FND Does Not Affect Lifespan
FND arises from a potentially reversible miscommunication between the brain and body rather than structural damage or degenerative disease to the nervous system, distinguishing it fundamentally from fatal neurological conditions like ALS, Parkinson's disease, or brain tumors. 2
No structural neurological damage, tissue destruction, lesions, or progressive neurodegeneration occurs in FND—symptoms reflect altered brain network function, not irreversible pathology. 2
The functional changes causing FND symptoms can improve with appropriate treatment, with 60-96% of patients reporting improvement after intervention, demonstrating the reversible nature of the disorder. 1, 2
The Real Burden: Quality of Life, Not Mortality
While FND does not threaten survival, it creates substantial disability:
Patients frequently experience high levels of distress, disability, unemployment, and reduced quality of life, but these reflect the burden of symptoms and associated stigma, not a life-threatening disease process. 1
Measurable improvements occur across mobility, depression, and quality of life domains after treatment, with realistic timelines for improvement being 12-25 months with multidisciplinary intervention. 1
Many individuals report significant psychological comorbidity including anxiety, depression, and dissociation, which are associated with symptom severity and diminished quality of life, creating a vicious cycle. 2
Important Caveats About Secondary Complications
Prolonged immobility or reduced activity can lead to secondary problems such as deconditioning and muscle atrophy, which can become more difficult to reverse if left unaddressed. 2
Maladaptive movement patterns and premature use of assistive devices can create new musculoskeletal problems such as secondary pain syndromes, reinforcing disability rather than promoting recovery. 2
Functional dysphagia can lead to unintended weight loss, malnutrition, and social withdrawal, representing a treatable complication rather than a fatal progression. 2
Prognosis and Recovery Patterns
Recovery often follows a pattern of symptom remission and exacerbation rather than linear improvement, with the potential for symptom reversal remaining throughout the disease course. 2
Early diagnosis and treatment are critical for optimal outcomes, as symptom duration is linked to prognosis, and many patients experience considerable delays before diagnosis. 2, 3
Assessment should occur across multiple outcome domains including symptom change, life impact, physical and psychological symptoms, and healthcare utilization rather than focusing solely on symptom elimination. 1