Incidence and Prevalence of Functional Neurological Disorder
A Systematic Review
Sara A. Finkelstein, Clare Diamond, Alan Carson, Jon Stone
Journal of Neurology, Neurosurgery & Psychiatry (2025)
- Clinical Study, Research Translation
Key Takeaways
- FND is more common than many realize. The best current estimate suggests at least 50 – 100 people in every 100,000 are living with FND—and possibly far more.
- New cases appear regularly. Annual incidence is roughly 10 – 22 per 100,000, meaning clinicians should expect to see new FND presentations every year.
- Children are affected too. Paediatric incidence ranges from 1 – 18 per 100,000, underscoring the need for child-friendly resources and early support.
- Numbers vary because methods vary. Differences in diagnostic criteria, data sources, and case-finding approaches drive wide swings in reported rates.
- Why it matters: Knowing how widespread FND is strengthens the case for better research funding, specialist clinics, and everyday resources that meet real-life needs.
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Overview
This summary looks at a large-scale review that gathered every available study measuring how many people develop or live with Functional Neurological Disorder (FND). By pooling data from 39 studies across multiple countries, the authors calculated conservative “best estimates” of incidence (new cases) and prevalence (existing cases) and highlighted gaps in current knowledge.
Discussion
What was done?
- Researchers searched PubMed and reference lists for any original study reporting FND incidence or prevalence (all ages, worldwide).
- 39 papers met criteria—19 on incidence, 21 on prevalence (some covered both).
- They rated each study’s quality, then compared numbers and extrapolated where needed.
Key findings
- Incidence (new cases): 10 – 22 per 100,000 people each year (all ages).
- Prevalence (living with FND now): minimum 80 – 140 per 100,000; broader range 50 – 1,600 depending on methods.
- Paediatric incidence: 1 – 18 per 100,000.
- FND likely out-numbers better-funded neurological illnesses such as multiple sclerosis or ALS.
Why the spread?
- Older studies used outdated “conversion disorder” definitions.
- Many studies looked at only one setting (e.g., neurology clinics) or one symptom (e.g., dissociative seizures), missing mixed-symptom cases.
- Community surveys may over- or underestimate when no specialist confirms the diagnosis.
Limitations & future directions
- Heterogeneous methods prevent a true meta-analysis.
- Newer DSM-5 criteria should guide future work.
- Including modern subtypes (functional dizziness, cognitive disorder) will refine counts.
Next Steps
If you have FND—or support someone who does—consider:
- Share the numbers. Bringing incidence and prevalence data to medical appointments can validate your experience and encourage referral to FND-informed care.
- Ask providers about local expertise. With FND affecting at least 1 in 1,000 people, many regions now host specialist clinics or virtual programs.
- Track symptoms over time. Consistent records help distinguish new events from ongoing patterns, supporting clearer communication with clinicians.
- Connect with community. Joining forums or peer groups reminds you that you are not alone and can spark practical coping ideas.
- Advocate for research. Larger, high-quality studies will drive better treatments—your voice (and participation, if feasible) moves the field forward.
Reference
Finkelstein SA, Diamond C, Carson A, Stone J. Incidence and prevalence of functional neurological disorder: a systematic review. J Neurol Neurosurg Psychiatry. 2025;96:383-395. doi:10.1136/jnnp-2024-334767
This summary is provided for informational purposes only and does not constitute medical, financial, or legal advice. It is not intended to replace professional consultation or treatment. Always consult qualified healthcare providers regarding your specific circumstances, symptoms, or questions.