Experts: Vaccines and Functional Neurological Disorder – A Complex Story

Hand Tremors

Some videos posted on social media showing people experiencing abnormal movements and walking difficulties after receiving a COVID-19 vaccine may be related to functional neurological disorder — a common neuropsychiatric condition.

Videos of people experiencing severe neurological symptoms, including convulsions and difficulty walking, purportedly after receiving a COVID-19 vaccine, have surfaced on Facebook, YouTube and other social media channels. The millions of people watching these videos might conclude that the vaccine is either quite dangerous to produce such symptoms or that the people in the videos are faking their symptoms. Both conclusions are incorrect, according to neurologist and psychiatrist David Perez, MD, MMSc, director of the Functional Neurological Disorders Unit at Massachusetts General Hospital (MGH).

In a JAMA Neurology Viewpoint, the authors explain that the COVID-19 vaccine may precipitate the development of functional neurological disorder (FND), a neuropsychiatric disorder with symptoms such as limb weakness, gait problems, jerky movements, tremor, and facial spasms. “The spread of these videos could fuel vaccine hesitancy by giving an overly simplistic impression of potential links between the vaccine and major neurological symptoms,” says Perez, the piece’s senior author. “Instead, these are symptoms of a real, brain-based disorder that sits at the intersection of neurology and psychiatry.”

FND is a disruption in the brain’s normal mechanisms for controlling the body and can be triggered by physical or emotional events, including head injury, a medical or surgical procedure, and vaccinations. “Some people with FND have a heightened awareness of their body and increased state of arousal and threat, which may hijack normal neural networks controlling voluntary movements,” says Perez. “FND teaches us quite a bit about the complexities of the human brain.”

An individual’s awareness of motor control may also be impaired with FND, adds first author David Dongkyung Kim, MD, clinical fellow in Behavioral Neurology-Neuropsychiatry at MGH: “The body is moving, but the individual doesn’t experience a sense of agency over their movements, such as tremors or movements of the trunk.”

Some, but not all, individuals vulnerable to developing FND may have experienced adverse life events or have chronic pain or a range of other medical or psychiatric conditions. “The biopsychosocial model involving an interplay of risk factors, triggering events, and perpetuating factors is how we currently understand FND,” says Kim. FND can, however, be treated with education, physical rehabilitation, and psychotherapy.

Neurologists and other health care professionals have an obligation to explain FND to the public, say the authors. “Helping people understand FND will bring this disorder into mainstream medical conversations, and transparently addressing concerns will better allow people to make informed decisions for themselves on receiving the COVID-19 vaccine,” says Perez.

Reference: “Helping the Public Understand Adverse Events Associated With COVID-19 VaccinationsLessons Learned From Functional Neurological Disorder” by David Dongkyung Kim, MD; Candice S. Kung, MD and David L. Perez, MD, MMSc, 9 April 2021, JAMA Neurology.
DOI: 10.1001/jamaneurol.2021.1042

Perez is an assistant professor of Neurology at Harvard Medical School. Candice Kung, MD, is a forensic psychiatry fellow at the University of Toronto.

2 Comments on "Experts: Vaccines and Functional Neurological Disorder – A Complex Story"

  1. PATRICIA KINCAID | March 24, 2022 at 4:34 pm | Reply

    Having experienced a granddaughter being diagnosed with FND within days of having the covid-19 vaccine I feel like doctors are closing their minds to the possibility of a connection to either the vaccine or an undiagnosed case of Covid itself. I think when the cause comes to light many will feel they have been let down by the “professionals”. In this case, the doctors said there was no data to support that possibility,yet felt no need to report it themselves to the CDC or anyone else. This,in one of the top children’s hospitals in the country. With no one reporting it, no data will ever be available. These are doctors? Covid-19 presents new challenges and requires new, bold thinking not regurgitation of past held beliefs.

  2. Patrica Kincaid I totally agree with you. I myself had adverse affects following the covid 19 vaccine or possible covid before testing. I was left frightened and scared for my life, i have since also been diagnosed with FND. Doctors repeatedly told me this was not the case and even now have not reported this as far as im aware.

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