Functional seizures

Functional Seizures Functional seizures, also known as psychogenic non-epileptic seizures (PNES), are episodes that resemble epileptic seizures but are not caused by electrical disruptions in the brain. They are classified as a type of functional neurological disorder (FND), which involves abnormal nervous system functioning without a structural neurological disease.

Symptoms

Functional seizures can present with a variety of symptoms, which may include:

• Convulsions or shaking
• Loss of consciousness or awareness
• Staring spells
• Sudden falls
• Jerking movements of the arms and legs
• Changes in sensation or perception

Unlike epileptic seizures, functional seizures do not have a consistent electrical pattern on an electroencephalogram (EEG) during the event.

Diagnosis

The diagnosis of functional seizures is often challenging and requires a comprehensive evaluation. Key steps in the diagnostic process include:

• Clinical History: A detailed history of the events, including triggers, frequency, and duration.
• Video EEG Monitoring: This is the gold standard for differentiating functional seizures from epileptic seizures. During video EEG, the patient's behavior and brain activity are recorded simultaneously.
• Psychiatric Evaluation: Since functional seizures are often associated with psychological factors, a psychiatric assessment may be necessary.

Causes

The exact cause of functional seizures is not fully understood, but they are believed to be related to psychological factors. Common associated factors include:

• Stress and Anxiety: High levels of stress or anxiety can trigger functional seizures.
• Trauma: A history of trauma, particularly psychological or emotional trauma, is often reported.
• Psychiatric Disorders: Conditions such as depression, anxiety disorders, and post-traumatic stress disorder (PTSD) are frequently associated.

Treatment

Treatment for functional seizures focuses on addressing the underlying psychological factors and may include:

• Cognitive Behavioral Therapy (CBT): A form of psychotherapy that helps patients identify and change negative thought patterns and behaviors.
• Stress Management Techniques: Techniques such as mindfulness, relaxation exercises, and biofeedback can be beneficial.
• Medication: While antiepileptic drugs are not effective, medications for associated psychiatric conditions may be prescribed.

Prognosis

The prognosis for individuals with functional seizures varies. With appropriate treatment, many patients experience a reduction in seizure frequency and improvement in quality of life. However, some individuals may continue to experience seizures despite treatment.

See Also

• Functional Neurological Disorder
• Psychogenic Movement Disorders
• Conversion Disorder
• Smith, J. (2020). "Functional Seizures: Diagnosis and Management." *Journal of Neurology*, 267(3), 789-795.
• Brown, R. J., & Reuber, M. (2016). "Psychogenic Non-Epileptic Seizures: A Review." *Clinical Psychology Review*, 45, 157-182.

NIH genetic and rare disease info

• NIH info on Functional seizures

Functional seizures is a rare disease.