FND and emergency care
FND / emergency bridge
Established-FND acute-care continuity failure. Public page, de-identified source-map summary only.
FND / ED / TDO bridge
Established-FND acute-care continuity failure
Public FND emergency-department literature explains the emergency-care pitfall: FND can present acutely like seizure, stroke, movement disorder, or other neurological disease. Project Fionigan adds the next category: an established-FND acute-care continuity failure.
That means the problem is not only whether acute-care staff can recognize a new possible FND presentation. The problem is whether the acute-care and legal system can preserve an already-established functional-neurology lane, communication-access plan, symptom pattern, and source record when the person is under pressure.
Core distinction
This was not only a confusing acute presentation
A public FND paper explains the ED pitfall.
The de-identified source map shows the FND / functional movement lane already existed.
Project Fionigan exists because the established lane can still collapse into a psychiatric/legal escalation when the source chain fails.
Intentionality matters
FND and malingering are opposite lanes
Public FND terminology separates FND from malingering by intentionality. Malingering involves deliberate feigning for secondary gain. FND symptoms are experienced as involuntary and unintentional.
That distinction matters when an already-documented functional-neurology presentation is interpreted through intent, behavior, or purely psychiatric framing. Calling documented FND “malingering” collapses the condition into the opposite diagnostic lane.
Communication access
The communication note is the access-control document
The private source map includes a pre-built emergency communication-access note. The public point is not the raw note itself. The point is that communication support, phone/voice support, speech difficulty, hand-use difficulty, and neurological framing were already documented as access needs.
The failure was not only diagnostic. The communication accommodation existed, but it did not reliably govern the handoff.
Two doorways
The legal frame can swallow the medical frame
An emergency custody / detention pathway can frame a person through mental-illness, risk, incapacity, custody, treatment, and voluntariness criteria. A functional-neurology pathway can frame the same moment through documented FND, non-epileptic episodes, abnormal movement, speech interruption, hand-use difficulty, and communication access.
The TDO/ECO-type legal doorway and the FND medical doorway can become competing interpretations of the same event. Project Fionigan is about preventing the wrong doorway from becoming the entire story.
Project Fionigan bridge
Anti-context-collapse
The diagnosis was there. The symptoms were there. The communication plan was there. The handoff failed.
Project Fionigan preserves the diagnosis, source context, communication method, symptom pattern, open questions, corrections, and next steps so that the next decision is not made from a collapsed snapshot.