What is FND and How to Keep Your Students Safe

While many are familiar with conditions like epilepsy, there are less commonly known disorders that may present similar symptoms called Functional Neurological Disorder (FND), formerly known as Psychogenic Non-Epileptic Seizures (PNES). Understanding FND and how to respond effectively to keep students safe can help faculty, staff, and administration feel prepared in an emergency.

What is FND?

FND, or Functional Neurological Disorder, can cause events that resemble epileptic seizures but “they cannot be explained by a neurological disease or other medical condition.” Let’s review some key differences and similarities between FND and Epileptic Seizures.

• It is unclear what causes FND seizures. Mayoclinic.org shares that it is “related to how the brain functions, rather than physical damage to the brain structure.”  If you compare the brain to a computer, nhsinform.scot likens it to a software issue rather than a hardware issue. However, the most recent fMRI studies show that there is evidence of physical differences of connectivity in the brains of some FND patients compared to healthy counterparts. While an epileptic seizure is a sudden burst of electrical activity in the brain.
• FND seizures can present in a variety of ways, just like epileptic seizures. Students may have uncontrollable jerking, twitching, loss of awareness, or loss of consciousness. Students with FND can also experience a range of other symptoms including paralysis, speech and hearing difficulties, memory and concentration loss, or other involuntary impairments.
• Similar to students with epilepsy, students experiencing FND seizures may have triggers related to stress, emotional factors, or lack of sleep. These students may have a history of trauma, and like with epilepsy, have a higher instance of mental health challenges such as anxiety and depression.

Preparation and training for all types of seizures will better support faculty and staff confidence when facing an emergency and allow them to deliver the right kind of support for students in crisis.

Treating FND

In the Comprehensive Epilepsy Center at Cincinnati Children’s Hospital Medical Center, epilepsy psychologists work alongside neurology providers to address FND. The psychologists on the team use evidence-based cognitive-behavioral therapies (CBT) to help individuals manage FND. CBT focuses on helping individuals better understand the brain-body connection, symptom triggers, and teaching skills to help patients return to normal activities..

“While FND is not the result of an underlying injury or disease, FND events are real and involuntary,” shares Dr. Clifford of Cincinnati Children’s.

Tips for Students Managing FND Symptoms

• Identity and develop a plan for managing FND triggers.
• Regulate your internal alarm system with daily practice of relaxation strategies (e.g., diaphragmatic breathing, mindfulness exercises, guided imagery, etc.).
• Remember that symptoms are sometimes a “false alarm” (e.g., symptoms are not due to injury or illness) and even if you have a FND event, you can handle it.
• Take back control by committing to a daily routine (e.g., regular sleep-wake schedule, regular meals, schoolwork, fun, etc.) and realistic activity goals (e.g., taking a walk, doing something with family/friends), despite FND symptoms.
• Support systems can help by encouraging you to: follow a regular routine, set reasonable goals for returning to normal activities, and use CBT skills to manage symptoms independently.

Supporting Students with FND in School

Once a student has been diagnosed with FND, it is important for school leaders to create individualized plans according to district or state policies. The names of these plans differ across states and districts, but common terms used include Student Health Plans, Emergency Action Plans, and 504 Plans. Plans may include:

Staff Training: Ensuring all relevant faculty and staff members, those who interact with the student regularly, understand and know how to respond to seizure disorders. Review district policies and disseminate all relevant information, where appropriate, to those interacting with students impacted by FND. While FND may differ from other epileptic seizures, consider reaching out to PSW to learn about training courses that best equip faculty and staff with knowledge to appropriately respond to seizure symptoms.

Mental Health Support: As FND can be linked to emotional stress and increase mental health challenges, providing the appropriate support may be beneficial to the student. Counselors or psychologists should be involved in supporting the students with FND, especially if their individualized health plan requires aid.

Open Communication with Family: As an FND diagnosis may require medical interventions, the student’s parent/ legal guardian will be encouraged to submit a seizure action plan to the school. To best support students, regular communication between the school, family, and healthcare providers is essential to ensure the student’s needs are met. This communication may help reduce the student’s stress or anxiety in the school environment.

Why FND Awareness Impacts School Safety

School leaders are looked to in fostering inclusivity and a supportive environment for all students. Training and awareness of FND symptoms can help faculty, staff, and affected students feel more confident in care provided in the school community.

Early identification, intervention, and collaboration are critical to keeping students safe and minimizing disruptions to their education. FND can impact a student’s mental health and academic performance. Equipping faculty and staff with knowledge and skills to respond effectively ensures students feel safer, supported, and understood.

Preparing Your Schools to Support Students with FND

Understanding FND and creating a management plan is critical for the student’s safety and well-being. Developing individualized safety plans; providing training; and supporting students’ mental health shows a spirit of proactivity and that school leaders are invested in the growth and success of all students.

Prioritizing FND awareness and education ensures that all faculty and staff are prepared to respond to students with this diagnosis. Compassion, support, and knowledge are essential tools to helping students with FND thrive.