On many occasions, when patients arrive at our unit, they bring with them an extensive battery of diagnostic tests whose conclusion is always the same: “no pathological findings.”
The first thing we need to observe (this is done by the otoneurologist) is whether the appropriate tests have been conducted to rule out any other organic pathology that could be causing the symptoms, but once this is done, the question is inevitable.
“If everything is fine, why am I still dizzy?”
Two answers quickly come to the patient’s mind.
They haven’t examined me properly, or I’m making it up.
Let’s start with the second option. No, you are not making it up, and to explain it to you, I need to introduce a term that may not sound familiar but is necessary for you to remember and, above all, understand very well. I’m talking about Functional Neurological Disorder (FND). According to FNDHope, Functional Neurological Disorder is a “problem with the functioning of the nervous system and the way the brain and body send and receive signals.”
To better understand this, we use the computer metaphor. We know that a computer has two parts: the hardware, which is the part we can touch, its structure, and the software, which consists of the programs that run through its circuits. FND would be a malfunction of the software, that is, of the information that circulates through the circuits, without any damage to the computer’s structure.
Medical tests analyze the state of the hardware (the structure), which has not suffered any damage, hence they show no findings. This does not mean that software problems are not real or as disabling as a hardware problem. We all know how frustrating it is when Word crashes just before submitting a document, right?
Well, the FND that affects our sense of balance is called Persistent Postural-Perceptual Dizziness (PPPD), but you can also find it as functional dizziness, and it is the primary cause of dizziness in ENT consultations, incredible, isn’t it?
I hope what you have read so far eliminates the suspicion of “they haven’t examined me properly” from your mind. Now you know what is happening, and it is essential for your recovery that you accept it. The organs that manage your balance are intact and ready to function correctly, but your brain needs to regain confidence in them. I don’t want to finish this entry without telling you that FNDs, being the product of erroneous learning by our brain, can be unlearned. In other words, they are POTENTIALLY REVERSIBLE.
