EMDR for functional neurological disorder: 2025 evidence
Functional neurological disorder (FND) may involve functional seizures, weakness, movement changes, sensory symptoms or cognitive difficulties. Symptoms are real and involuntary; they should not automatically be attributed to trauma or diagnosed only because a test is normal.
A 2025 randomised study of 50 participants found that an FND-specific EMDR protocol added to neuropsychiatric care was feasible and acceptable, with clinical signals supporting a larger trial. It was not a definitive efficacy trial. EMDR is not yet an established primary FND treatment and cannot replace neurological diagnosis, physiotherapy, rehabilitation or multidisciplinary care.
First, a positive and explained diagnosis
NHS inform states that FND should be diagnosed through recognisable clinical features, not simply because scans or other tests are normal. Depending on symptoms, neurology and investigations may be needed to distinguish epilepsy, stroke, injury, migraine or other causes.
Trauma, stress, pain, illness or psychological factors may matter for some people, but they are not required and do not establish one cause. Presenting FND as imagined, fabricated or always caused by repressed memories is inaccurate.
What MODIFI did and did not establish
MODIFI assigned 50 adults to FND-focused EMDR plus neuropsychiatric care or neuropsychiatric care alone. Its primary objectives concerned recruitment, adherence, measure completion, safety and acceptability.
The study found feasibility and favourable clinical signals, while its authors called for a full-scale trial to establish efficacy. Exploratory signals cannot support promises of seizure reduction, cure or superiority over established care.
Treatment is commonly multidisciplinary
Care may include diagnostic explanation, specialist physiotherapy, occupational therapy, psychotherapy, neurology, neuropsychiatry and treatment of co-occurring problems. The mix depends on subtype and individual needs.
If EMDR is proposed, ask whether it targets PTSD, memories around onset, fear of symptoms or an FND-specific protocol. A psychological target cannot replace motor rehabilitation or turn every episode into a traumatic memory.
Safety with seizures or new symptoms
A first seizure, loss of consciousness, injury, breathing difficulty, new neurological symptoms or a changed pattern requires urgent medical assessment according to context. An episode should not be assumed to be functional from a distance.
Ask who confirmed the diagnosis, which discipline coordinates care, which outcome will be measured and what happens if seizures, disability or dissociation increase. The therapist should understand both trauma and FND and be able to coordinate care.
Frequently asked questions
Is EMDR proven for functional neurological disorder?
Not yet as an established treatment. The 2025 study showed feasibility and promising signals but stated that a definitive trial is needed.
Does FND mean symptoms are psychological or made up?
No. Symptoms are real and involuntary. Diagnosis relies on positive clinical features and may require neurological and multidisciplinary care.
Does EMDR replace physiotherapy or neurology?
No. It may be studied or considered for defined targets, but cannot replace diagnosis, rehabilitation or treatment of other conditions.
Sources and scope
Informational content based on guidelines and professional bodies. It does not diagnose, recommend individual treatment or replace clinical assessment.