A team of experts from the American Academy of Neurology (AAN) reviewed the latest evidence on the most effective ways to treat and manage functional seizures and developed a clinical practice guideline for health professionals. Doctors will use this guideline to help properly diagnose and manage this condition.
What are functional seizures and how do they differ from other types of seizures?
Functional seizures, previously called “nonepileptic” or “psychogenic” seizures or attacks, are a common type of functional neurologic disorder (FND). These seizures can look or feel like epilepsy or fainting, but they have different causes and features. Typical features of functional seizures include tightly shut eyes at the start of the event or limb movements that are mismatched in their pattern.
What does the research say?
Certain psychological treatments, including specific behavioral therapies or motivational interviewing combined with psychotherapy, can help reduce the number and frequency of seizures or improve quality of life for people with functional seizures. These treatments can help you learn skills to help manage the events and understand why they’re happening. In some people, psychological treatments can help seizures stop altogether.
What should I know about the recommendations in the guideline?
Some people with functional seizures might experience discrimination from doctors or the general community who don’t understand the condition. To help reduce this discrimination, the AAN has recommended that doctors provide you with a diagnosis in a clear, empathetic, and supportive way.
Your doctor should ask about the details of your seizures and may conduct tests such as a video EEG (a test that records video and the electrical activity in your brain) to diagnose the condition. These tests can help determine whether you are having functional seizures, seizures due to epilepsy, or a combination of both. Talking to people who have seen your seizures or reviewing recorded videos of your seizures may also help your doctor accurately diagnose the condition.
Once an accurate diagnosis is made, your doctor will talk to you about potentially effective treatments to help reduce seizures. Your doctor should include you and your family or other trusted care partners in decisions about treatment.
If you are currently taking antiseizure medications, such as benzodiazepines, for functional seizures, your doctor should evaluate whether they are right for you. Your doctor should also talk to you about certain psychological treatments that may help manage seizures.
How can I best prepare for my appointments?
- Bring a copy of this article to your appointment
- If possible, ask a friend or family member to record a video of your seizures
- Ask a trusted friend or family member who has seen one of your seizures to attend the appointment with you or be available by phone
What should I ask my doctor?
- Are my seizures caused by epilepsy, are they functional seizures, or a combination of both?
- What do we need to do to diagnose my seizures?
- Are there other conditions or disorders I should be screened for?
- What treatment do you recommend to reduce my seizures or make them more manageable?
- Do you think seeing a mental health professional would help manage my seizures?
Where can I find more information about functional seizures?
The following trusted organizations provide resources for people with functional seizures and their care partners:
The full AAN guideline and additional resources for your health care providers are available at AAN Guidelines.
