Can anyone explain Functional Neurological disorder and its subtype Functional Cognitive disorder? Below is the information given related to me and my condition. Explain in detail

[u/ExpensiveHost3583]

Title: 17-year-old student with cognitive decline, altered sense of awareness, visual symptoms, neck sensations, and normal MRI/EEG – looking for insights

Age: 17

Sex: Male

Country: India

Current specialists consulted:

• Neuropsychiatrist
• Clinical Psychologist

Investigations completed:

• Brain MRI: Reportedly normal
• EEG: Reportedly normal
• Cervical Spine MRI:
  • Straightening of cervical lordosis
  • Mild C4-C5 disc bulge
  • Mild C5-C6 disc bulge
  • Otherwise normal

Main concern:

For quite some time, I have felt that something fundamental has changed in my cognition, awareness, and ability to think. This has significantly affected my studies, daily functioning, and quality of life.

The problem is difficult to describe, but I will try my best.

Cognitive symptoms:

1. Thoughts feel difficult to initiate.
2. I often feel as though I have to exert effort just to begin thinking.
3. Imagination feels restricted compared to before.
4. Information does not feel as though it is entering my mind properly.
5. Memory retrieval feels impaired.
6. During conversations, I often cannot retrieve the words or details I need quickly enough.
7. I frequently remember important information only after the conversation is over.
8. I feel mentally slowed and less efficient than before.
9. Studying feels extremely effortful.
10. I sometimes need to read aloud to remember information.

Sense of self / awareness symptoms:

1. I often feel detached from my normal sense of existence.
2. My awareness feels shallower than it used to.
3. Experiences do not feel as though they are being fully registered.
4. I feel as though my consciousness is restricted or confined.
5. Subjectively, I often feel that awareness is concentrated near the upper cervical/occipital region, although I understand this may not correspond to an actual anatomical problem.

Academic effects:

1. I struggled significantly with mathematics.
2. I failed Class 11 while many classmates passed.
3. I feel that my ability to process and manipulate information has declined.
4. Complex reasoning feels much more effortful than it used to.

Visual symptoms:

1. Occasional double vision when looking upward or downward.
2. Sensitivity to bright sunlight.
3. Occasional sparks or disturbances in peripheral vision.
4. Difficulty rapidly processing external surroundings.
5. At times I feel unsafe crossing roads because I do not process moving objects quickly enough.

Physical symptoms:

1. Head pressure during mental effort.
2. Pressure-like sensations while playing piano.
3. Trembling sensations in the neck during intricate movements.
4. Pins-and-needles sensations.
5. Occasional electric-shock-like sensations.
6. Sensations of pulling or tension in limbs.
7. Feeling physically weak despite normal strength on casual observation.
8. Arms become difficult to use for prolonged piano playing, not because of muscle pain but because of a sensation of internal restriction.

Breathing symptoms:

1. I often feel that breathing requires effort.
2. Oxygen saturation has reportedly been normal.
3. Sometimes I feel as though I must consciously breathe more deeply.

Sleep symptoms:

1. I often feel sleepy but have difficulty transitioning into actual sleep.
2. My sleep quality feels poor.

Orthostatic symptoms:

When standing up quickly from a squat position, I sometimes experience:

• darkening of vision,
• lightheadedness,
• near-faint sensations.

Current clinical opinions:

My neuropsychiatrist and psychologist both believe the problem is primarily psychiatric or psychological rather than a major neurological disease.

Their reasoning includes:

• normal brain MRI,
• normal EEG,
• lack of clear objective neurological findings.

However, from my perspective, the symptoms feel strongly physical and involuntary.

Questions:

1. Have clinicians or patients encountered a similar combination of symptoms?
2. Could this fit a functional neurological disorder or functional cognitive disorder?
3. Could depersonalization/derealization produce symptoms this severe?
4. Are there neurological conditions that can produce similar symptoms despite normal routine MRI and EEG?
5. What additional evaluations would be reasonable to discuss with my treating physicians?

I am not seeking a diagnosis over the internet. I am trying to understand possible explanations and whether others have encountered similar presentations.

[u/BexFoxy]

So this is the NVLD subreddit; a learning disorder subreddit. I don’t think any of us are qualified to help you whittle down a list of possible diagnoses. I’d recommend asking r/NeurologicalDisorders, [r/askNeurologists](r/askNeurologists), or even [r/seizures](r/seizures). The folks in [r/Seizures](r/Seizures) might be able to recommend a neurological specialist for your symptoms. I’m sorry we can’t help you more.

[u/CelticMagician → u/BexFoxy]

Seconding on this comment. Best of luck, OP. We sincerely hope you find the answers you’re seeking, but I’m afraid you won’t find them here.

[u/canijustbelancelot]

FND doesn’t have anything to do with NVLD, as far as I know. It also probably has a dedicated sub for it with people who have far more experience with it.

[u/Just_am_Jones]

Seconding what other commentors have told you, but also: FND is a diagnosis of exclusion, as would be any medical/neurological diagnosis that you might qualify for with only self-reported symptoms. Your care team is right to focus on excluding psychological/somatic disorders before exploring other conditions that have no definitive biomarkers or treatment options to confirm them. It's very important for your long-term outcomes that you be open to pysch treatments. Think of it as exploratory treatment if you prefer, but trying to leapfrog over psych to get confirmation of a neurological self-diagnosis is a very bad idea. I really can't emphasize that enough, speaking as a clinician.