Research Topic

Functional Seizures: A State of the Art Review

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Functional seizures can be defined as a sudden and time-limited alteration of consciousness, associated with a disturbance in controlling motor, sensory, automatic, cognitive, emotional and/or behavioural functions. They are thought to represent an experiential or behavioural response to emotional or social ...

Functional seizures can be defined as a sudden and time-limited alteration of consciousness, associated with a disturbance in controlling motor, sensory, automatic, cognitive, emotional and/or behavioural functions. They are thought to represent an experiential or behavioural response to emotional or social distress caused by internal or external stimuli. Because the symptoms have a neurological appearance, patients with functional seizures typically present to, and are diagnosed and initially managed by neurologists, rather than psychiatrists.

Patients with functional seizures are as common as those with Parkinson’s disease or multiple sclerosis. Up to 40% of patients evaluated in in-patient epilepsy monitoring for refractory seizures are diagnosed with functional seizures, while up to 50% of patients with refractory ‘status’ have been diagnosed with functional seizures rather than epilepsy. Mortality rates among patients with functional seizures are comparable to those patients with epilepsy. The cost of functional seizures when left undiagnosed has been estimated to be equivalent to the cost of treating epilepsy over the lifetime of the patient, and there are significant but unquantifiable, socioeconomic costs for patients and their families. Treatment for functional seizures is limited in both scope and availability. Cognitive behavioural therapy is the only treatment with a robust evidence base, and yet only a proportion of patients have a good outcome following treatment.

Despite the considerable prevalence, cost and multifarious impact of functional seizures, our understanding of it and treatment options are limited. Reflecting this fact, the National Institute of Neurological Disorders and Stroke (NINDS) has assigned research into the aetiology, diagnosis and treatment of functional seizures as one of its Epilepsy Benchmarks.

In this Research Topic we welcome original articles as well as state of the art review papers about the historical aspects, epidemiology, aetiological models, clinical features, diagnosis and treatment of functional seizures.


Keywords: Functional Seizures, Psychogenic Non-Epileptic Seizures, Epilepsy, Non-Epileptic Attack Disorder


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