Functional neurological disorder and its relationship to COVID-19 vaccines

According to a standpoint article published in JAMA Neurology, better education and awareness of functional neurological disorders (FND) is needed to make vaccination programs like those for COVID-19 more successful.

As of January 2021, 97.3 million doses of the COVID-19 vaccine had been administered. These vaccines were highly effective and safe, with some side effects such as fever, fatigue, nausea, and pain at the injection site.

Recently, videos were circulated online discussing key neurological side effects such as continuous limb and trunk movement or difficulty walking after vaccination against COVID-19. Some of these videos have been viewed a million times and likely resulted in a hesitant vaccine.

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In at least one case reported in the news, a doctor has linked these symptoms to FND or conversion disorder. The Functional Neurological Disorder Society issued a statement indicating that the features depicted in this video appear to be consistent with FND.

The authors of this point of view comment emphasized the fact that FND is one of the most commonly observed conditions in outpatient neurology and may not be vaccine-related.

FND is a brain-based disorder that is characterized by the development of a range of neurological symptoms that are aggravated by biological, psychological, and / or environmental factors. FND can be triggered by physically / emotionally stressful events such as injuries, medical or surgical interventions, or vaccinations. Rather than being caused directly by these events, factors such as expectations, beliefs, arousal, and emotional processing can play a mechanistic role in the pathophysiology of this disorder.

Treatment for FND includes education about the disorder, physical rehabilitation, and cognitive behavioral therapy. These approaches aim to retrain the brain to return to automatic movement and provide coping strategies for patients to help in lowering levels of arousal.

The authors of the comment concluded that doctors should explain the nature of FND, noting that these symptoms are real but not directly caused by vaccine effects. They added, “Transparency and effective communication are needed more than ever in our society, and a condition as widespread and potentially debilitating as FND can no longer be marginalized and overshadowed. Effective communication will help educate the public and reduce anxiety so that patients can make informed decisions about receiving the vaccine to reduce their risk of COVID-19. “


Kim DD, Kung CS, Perez DL. Helping the Public Understand Adverse Events Related to COVID-19 Vaccination: Lessons from Functional Neurological Disorders. JAMA Neurol. Published online April 9, 2021. doi: 10.1001 / jamaneurol.2021.1042

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