Functional Seizures: When Seizures Have No Epileptic Cause

Table of Contents

1. What Functional Seizures Are
2. The Many Names and the Retreat From "Pseudoseizures"
3. How Common They Are and Who Has Them
4. Functional Seizures and Epilepsy in the Same Person
5. How the Diagnosis Is Made
6. Features That Help and Features That Mislead
7. The Long Wait for a Diagnosis
8. Harms Reported When Functional Seizures Are Treated as Epilepsy
9. Long Seizures and Emergency Signs
10. How the Diagnosis Is Explained
11. What the Treatment Trials Found
12. The American Academy of Neurology Guideline
13. Outcomes, Prognosis and Mortality
14. What Is Not Known
15. Key Research Papers
16. Connections
17. Featured Videos

What Functional Seizures Are

A 2021 paper summarising two expert seminars, held by the American Epilepsy Society and the Functional Neurological Disorder Society, describes the condition as episodes of altered behaviour, awareness, sensation or sense of bodily control that often resemble epileptic seizures, but without the abnormal, excessive or synchronised electrical activity in the brain that defines an epileptic seizure. The large British trial known by the short name CODES described dissociative seizures as events resembling epilepsy or fainting, with characteristic features that allow them to be told apart from other medical conditions.

Two broad patterns are described. In "hyperkinetic" events there is a lot of movement: shaking, jerking, thrashing. In "hypokinetic" events the person goes still, falls or stops responding, a little like a faint. In the 698-person British study described below, people with mostly hyperkinetic events reached a diagnosis sooner than people with mostly hypokinetic events, and the authors noted that the still, unresponsive type may carry a higher risk of delayed diagnosis and treatment.

The condition sits inside the wider family of functional neurological disorder, which the parent page covers in full, including its brain-network model and the history of the old word "hysteria". This page stays with the seizure form only.

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The Many Names and the Retreat From "Pseudoseizures"

Few conditions have had so many names. A 1997 letter in the Journal of Neurology, Neurosurgery and Psychiatry was titled "Pseudoseizures or non-epileptic seizures (NES); 15 synonyms". The 2021 seminar paper lists psychogenic non-epileptic seizures, dissociative seizures, functional seizures, non-epileptic attack disorder, pseudoseizures and conversion disorder with seizures "and many other labels besides", and states that the choice of name is not merely academic: it affects how patients respond to and understand their diagnosis, and how they find their way through health-care systems.

"Pseudo" comes from the Greek word for false. "Pseudoseizures" was common in older medical writing; the recent expert papers and the 2025 guideline cited on this page use other names instead. Each remaining name carries its own idea of cause:

• Psychogenic non-epileptic seizures says the cause is psychological, and defines the events by what they are not.
• Dissociative seizures points to dissociation, a temporary disconnection of awareness, memory or control. It is the name used in the CODES trial and in British services.
• Functional seizures says the problem is in how the brain is working, without naming a cause.

A 2020 review by Asadi-Pooya and colleagues searched the medical literature for papers on these names and found 757 articles, of which 30 met its criteria; the authors described them as generally of low quality and stated that their proposal reflected their own opinions. They concluded that "functional seizures" met more of the criteria for an acceptable label than the other common terms: it appeared acceptable to patients, was relatively popular with clinicians, and was neutral about cause, while "dissociative", "conversion" and "psychogenic" are not. One of the four authors leads a nonprofit patient group, FND Hope. The 2025 American Academy of Neurology guideline uses "functional seizures" in its title. The 2021 seminar paper presents the debate as still open, as a first step toward seeing whether agreement on one label is possible.

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How Common They Are and Who Has Them

Counting functional seizures is hard, because many people are first labelled as having epilepsy, and many never reach a specialist centre. Two population studies give the best figures:

• Norway, 2010–2019. Villagrán and colleagues reviewed the medical records of everyone in one Norwegian county coded with seizure-type conversion disorder or unexplained convulsions. The prevalence of active functional seizures (events within the past 5 years) was 23.8 per 100,000 people, or 10.6 per 100,000 when only video-EEG-confirmed cases were counted. The highest prevalence was in people aged 15 to 19: 59.5 per 100,000. About 3.1 new cases per 100,000 people were found each year. The authors described it as the first population-based estimate of prevalence.
• A Scottish first-seizure clinic. Duncan and colleagues followed every first presentation from a population of 367,566 people for 3 years. Functional seizures were diagnosed in 68 people, 54 of them confirmed on video recording with EEG, giving an incidence of 4.90 per 100,000 people per year.

The largest description of who is affected comes from the screening phase of the CODES trial: 698 adults from 27 neurology and epilepsy clinics in the United Kingdom. In that group:

• 74% were women. Women were more common at every age, but the share of men rose with age at onset: 77% of the women but only 59% of the men had their first seizure by age 40.
• The most common age at onset was 19; the median age at onset was 28.
• More than half lived in the most deprived areas, and more than two-thirds were unemployed.
• 30% were taking antiepileptic drugs, more often the men.

Trauma is often discussed in connection with functional seizures. A 2026 meta-analysis of 34 studies, covering 31,711 people with functional or dissociative seizures, found that 37.7% had been diagnosed with post-traumatic stress disorder or had symptoms likely to meet its criteria. The authors stressed the other side of the figure as well: most people with functional seizures did not meet this criterion, so post-traumatic stress disorder is not a universal feature of the condition. Anxiety and depression are also common, and the American Academy of Neurology guideline recommends that clinicians look for co-occurring psychiatric disorders in everyone with this diagnosis.

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Functional Seizures and Epilepsy in the Same Person

Having one condition does not rule out the other. A 2018 systematic review and meta-analysis by Kutlubaev, Xu, Hackett and Stone pooled observational studies of people of any age with both diagnoses:

• On average, 22% of people with functional seizures also had epilepsy (range across studies 0% to 90%).
• On average, 12% of people with epilepsy also had functional seizures (range 1% to 62%).

The authors warned that the studies differed so much that these pooled figures need caution, and that a dual diagnosis is especially common among patients referred to specialist services. Few studies have looked at how people with both conditions fare over time.

The reverse problem is common too: an epilepsy diagnosis given in error. In the 698-person British study, 27% of participants reported a previous epilepsy diagnosis, and clinicians judged nearly half of those epilepsy diagnoses to have been wrong. In the Australian video-EEG cohort described in the outcomes section, 674 of 5,508 people monitored (12.2%) were diagnosed with functional seizures, and 175 (3.2%) with both conditions. The American Academy of Neurology guideline recommends that clinicians evaluate everyone diagnosed with functional seizures for co-occurring epilepsy.

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How the Diagnosis Is Made

Video-EEG is the reference test. An electroencephalogram (EEG) records the brain's electrical activity through small sensors on the scalp. In video-EEG monitoring, usually done over several days in a hospital epilepsy monitoring unit, a camera films the person while the EEG runs. When a typical event is caught on video and the EEG during it shows none of the electrical changes of an epileptic seizure, the diagnosis is at its most certain.

The ILAE staged approach. Video-EEG is not available everywhere or for everyone. In 2013 the International League Against Epilepsy (ILAE) Nonepileptic Seizures Task Force, led by LaFrance, published minimum requirements for the diagnosis. The task force reviewed history, routine EEG, ambulatory EEG, video-EEG, nerve and hormone tests, brain imaging, memory and thinking tests, hypnosis and the analysis of how patients talk about their seizures. It set out four levels of diagnostic certainty, possible, probable, clinically established and documented, which rise with what is available: the history, a witnessed event, and investigations, with video-EEG at the top. The task force's stated aim was to bring more clarity to how the diagnosis is reached and how certain it is.

Smartphone videos. Families now often film events. In the OSmartViE study at 8 United States epilepsy centres, 44 outpatients brought a smartphone video and later had video-EEG monitoring; 30 turned out to have functional seizures, 11 epileptic seizures and 3 other non-epileptic events. Experts reviewing the phone video alone predicted a video-EEG diagnosis of epileptic seizures correctly 89.1% of the time. Adding the video to the history and examination raised the share of correct diagnoses from 78.6% to 95.2%. Trainee doctors were less accurate than experts, despite being more confident. The guideline recommends that clinicians gather the history and a description of the events, including smartphone videos, from both patients and witnesses.

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Features That Help and Features That Mislead

Doctors look closely at what happens during an event. A 2010 review by Avbersek and Sisodiya checked which signs are actually supported by research. It found 34 studies that used video-EEG to confirm the diagnosis and counted a sign as well supported only when at least two controlled studies showed it was useful and the other studies agreed.

The signs with good support for a functional seizure rather than an epileptic one were:

• a long duration;
• an event that seems to come from sleep while the EEG shows the person was awake;
• a fluctuating course, with movements that wax and wane;
• movements of the limbs that are out of step with each other;
• pelvic thrusting;
• side-to-side movement of the head or body;
• eyes closed during the event;
• crying during the event;
• remembering what happened during the event;
• no confusion afterwards.

Loud, snoring breathing after the event pointed the other way, toward a generalised tonic-clonic (convulsive epileptic) seizure. The review's central conclusion was that the final diagnosis has to take in all the available information and must not rest on any single sign.

What can mislead. Shaking, stiffening and falling occur in both conditions, so the overall look of an event is not enough. The EEG itself can mislead when it is over-read. Benbadis and Tatum reviewed 15 EEG recordings from people later diagnosed with functional seizures whose EEGs had been reported as showing epileptic activity. In 12 of the 15, the patterns called abnormal were simply normal fluctuations of background brain rhythm. In a 2013 paper Benbadis named the over-reading of normal EEGs as a major contributor to the misdiagnosis of epilepsy, and described cases in which a wrong seizure diagnosis rested only on an "abnormal" EEG. A normal EEG between events does not rule out epilepsy either, which is why capturing an actual event matters.

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The Long Wait for a Diagnosis

The best-known figure comes from Reuber and colleagues in Bonn, who studied 313 consecutive patients in 2002. On average they were diagnosed 7.2 years after their seizures began, with very wide variation (standard deviation 9.3 years). Three things went with longer delays: being younger, having EEG "spikes" between events, and being treated with antiseizure drugs. Other patient factors did not explain the variation, and the authors suggested that doctor-related factors contributed to the delays.

The delay is not fixed. In the Scottish first-seizure clinic, where new patients were assessed quickly, the median delay was 0.6 years. Where people are seen, and by whom, makes a large difference.

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Harms Reported When Functional Seizures Are Treated as Epilepsy

Antiseizure drugs act on epileptic electrical activity, which is not the mechanism of functional seizures. The 2025 guideline found no evidence that antiseizure drugs or benzodiazepine sedatives help functional seizures. Its recommendations are that clinicians not prescribe benzodiazepines or antiseizure medications to people with functional seizures who have no epilepsy or other reason for these drugs, that they tell patients about the risks and the lack of evidence of benefit, and that they taper the drugs off in people with no other indication for them.

The most serious reported harms happen in emergencies. A long functional seizure can be mistaken for status epilepticus, a prolonged epileptic seizure that is a medical emergency. Two studies measured how often this happens:

• Two status epilepticus trials. Jungilligens, Michaelis and Popkirov reanalysed individual patient data from two large United States emergency trials. Of 980 people aged 8 or older diagnosed and treated for status epilepticus, 79 (8.1%) were finally discharged with a diagnosis of prolonged functional seizures. Among adolescents and young adults the share was 20.1%. Side effects including breathing suppression and intubation (a breathing tube) were documented in 26% of these patients who received benzodiazepines in one trial, and in 33% of those who received an additional second-line drug in the other. Across both trials, one in five was admitted to intensive care. The authors called the misdiagnosis a common and widespread problem with harmful consequences.
• Patients intubated for convulsions. Viarasilpa and colleagues reviewed 148 consecutive patients put on a breathing machine for emergency convulsive symptoms between 2012 and 2017, excluding those with acute brain injury or progressive brain disease. Twenty-four (16%) had functional seizures rather than status epilepticus, about one in six.

Other reported harms are quieter: years of drug side effects, repeated emergency visits, and driving and work restrictions based on an epilepsy diagnosis the person does not have.

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Long Seizures and Emergency Signs

Hospitals and seizure first-aid guidance treat a convulsive seizure lasting more than 5 minutes as an emergency, along with seizures that follow one another without the person waking in between, an injury, trouble breathing afterwards, a seizure in water, and a first-ever seizure. These signs apply whatever the cause, because a bystander cannot tell a functional seizure from an epileptic one by watching. The emergency trial figures above show that teams treating for status epilepticus sometimes cannot tell them apart either. Only an EEG recorded during the event settles it.

The intubation study above found that, without a clear brain injury, a set of six simple features (age under 50, female sex, white ethnicity, a history of psychiatric disorder, no history of a brain abnormality and a maximum systolic blood pressure below 140) helped flag likely functional seizures among intubated patients. Its authors stated that these features cannot make the diagnosis, and that urgent neurology review may prevent unneeded intubation.

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How the Diagnosis Is Explained

How the diagnosis is given has been studied as a step of care in its own right. The guideline recommends that clinicians give a specific diagnostic name and the reasons for it, speak respectfully, avoid stigmatising behaviour, share decisions about treatment and keep providing care after the diagnosis.

A team in Sheffield tested a structured approach: a patient information leaflet plus a guide for neurologists on how to explain the diagnosis. In the first study, 50 newly diagnosed patients were told by 10 different neurologists:

• 94% found the leaflet easy to understand, and 94% said their questions had been answered;
• 70% got what they wanted from the consultation, and only 4% reported feeling angry;
• 86% accepted that psychological factors at least contributed to their seizures;
• after 3 months, 14% were seizure-free and 63% reported more than a halving of seizure frequency.

A follow-up study by the same group, with no treatment beyond the explanation, was more sobering. After 6 months, median seizure frequency had gone from 10 to 7.5 a month, a change that was not statistically significant. Of 44 participants, 7 (16%) were seizure-free and another 10 (23%) had more than halved their seizures, while quality of life and other measures had not improved. The authors concluded that further treatment was needed for this group.

The Scottish first-seizure clinic reported a stronger early response in people whose seizures had begun recently: at 3 months, 27 of 54 (50.0%) were free of events, and for 24 of those 27 the events stopped as soon as the diagnosis was explained. By 6 months, 24 of 54 (44.4%) were event-free, showing that some people relapsed quickly. Being unemployed predicted a poorer early outcome.

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What the Treatment Trials Found

The treatments tested are mainly forms of psychological therapy, especially cognitive behavioural therapy (CBT), a structured talking therapy that works on the links between thoughts, feelings, body sensations and behaviour, adapted for seizures.

The CODES trial (2020)

CODES, led by Goldstein at King's College London and funded by the UK National Institute for Health Research, is the largest randomised trial in this condition. Adults with dissociative seizures in the previous 8 weeks, and no epileptic seizures in the previous 12 months, were randomly assigned to standardised medical care from neurologists and psychiatrists, or to the same care plus cognitive behavioural therapy designed for dissociative seizures. Between 2015 and 2017, 368 people were enrolled: 186 to the therapy group and 182 to medical care alone.

• Main result, null. At 12 months, the number of seizures in the previous month did not differ significantly: a median of 4 in the therapy group against 7 with medical care alone (rate ratio 0.78; p=0.144).
• Better in the therapy group: how bothersome the seizures were, the longest seizure-free stretch in the previous 6 months, quality of life on a health-today scale, work and social functioning, overall psychological distress, the number of other physical symptoms, improvement as rated by both patients and clinicians, and satisfaction with treatment.
• Not different: seizure severity, complete seizure freedom in the last 3 months, the share of people whose seizures fell by more than half, short-form physical and mental health scores, anxiety and depression scores.
• Safety. Adverse events were similar: 31% of the therapy group and 29% of the medical-care group reported at least one.

The trial protocol reported p values without correction for multiple comparisons, so the secondary results are less firm than they look. The authors concluded that adults with dissociative seizures might benefit from adding seizure-specific cognitive behavioural therapy to specialist care, and that future work is needed to find who benefits most.

The LaFrance pilot trial (2014)

Before CODES, LaFrance and colleagues ran a small pilot trial at 3 United States academic centres. Thirty-eight outpatients were randomly assigned to one of 4 arms for 16 weeks; 34 were analysed. The arms were the antidepressant sertraline alone, a cognitive behavioural therapy-informed psychotherapy alone, the psychotherapy with sertraline, or treatment as usual. Within each arm, seizures fell by 51.4% with psychotherapy alone and by 59.3% with psychotherapy plus sertraline, both statistically significant, and the psychotherapy arm also improved on depression, anxiety, quality of life and overall functioning. The sertraline-only arm did not show a significant fall in seizures, and treatment as usual showed no significant change. These were comparisons within each small group against its own starting point, not a large head-to-head test.

Pooled analyses

• Moro and colleagues, 2024. Three randomised trials of cognitive behavioural therapy plus standardised medical care against medical care alone, with 228 and 222 participants. The therapy was linked to seizure freedom at the end of treatment (odds ratio 1.98), a small drop in anxiety and better quality of life; depression did not differ. There was no statistically significant rise in suicidal thoughts or self-harm, and drop-out was similar. The authors described the evidence as high quality.
• Carlson and Nicholson Perry, 2017. Thirteen studies of several kinds of psychological therapy, including uncontrolled before-and-after studies and case series, with 228 participants. 47% were seizure-free on completing therapy, and among 137 participants in 10 studies, 82% of those who completed treatment had at least a halving of seizures. The authors noted that the studies varied widely in design and quality. Because many lacked a comparison group, these figures cannot show how much of the change was due to the therapy itself.

Specialist physiotherapy is also used for functional neurological disorder, mainly for movement symptoms; the parent page covers the largest physiotherapy trial.

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The American Academy of Neurology Guideline

In December 2025 the American Academy of Neurology published a practice guideline on managing functional seizures, by a panel led by Tolchin that included neurologists, psychiatrists, psychologists and representatives of two nonprofit patient groups, FND Portal and FND Hope. The panel's systematic review, covering everything published up to 25 February 2025, found only 12 studies, all rated Class II or III in the academy's evidence system, below the top class. It concluded that psychological interventions are "possibly effective" for:

• raising the chance of becoming free of functional seizures;
• lowering seizure frequency;
• reducing anxiety;
• improving health-related quality of life and social functioning.

Its main recommendations to clinicians, as the guideline states them, are:

• gather the history and event descriptions, including smartphone videos, from patients and witnesses, and obtain video-EEG of all typical events where feasible;
• evaluate for co-occurring psychiatric disorders and co-occurring epilepsy;
• speak respectfully, avoid unnecessary harm and avoid stigmatising behaviour;
• give a specific diagnostic label and its rationale, share treatment decisions and provide continuity of care;
• where psychological treatment is indicated, explain its possible benefits and risks and refer interested patients, involving family, caregivers or others in the support network;
• do not prescribe benzodiazepines or antiseizure medications without co-occurring epilepsy or another reason for them, and taper antiseizure medications in people with no other indication.

The guideline also lists gaps in the evidence and areas for future research.

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Outcomes, Prognosis and Mortality

Long-term seizure outcome. The most-cited long-term cohort is from Bonn. Reuber and colleagues surveyed 164 adults a mean of 11.9 years after their seizures began and 4.1 years after diagnosis. 71.2% were still having seizures, and 56.4% depended on social security, a share that rose with longer follow-up. Outcomes were better in people with more education, a younger age at onset and diagnosis, less dramatic attacks, fewer other unexplained physical symptoms and lower dissociation scores. The authors described the outcome as poor but variable. That cohort was diagnosed before the modern treatment trials, and the shorter-term studies above show that many people improve, at least for a time, after a clear diagnosis.

Mortality. Two large studies found a raised death rate:

• Melbourne, Australia. Nightscales and colleagues linked 5,508 people monitored on video-EEG at 3 hospitals between 1995 and 2015 to the national death index. People diagnosed with functional seizures died at 2.5 times the rate of the general population, and those under 30 had an 8-fold higher risk. Their death rate did not differ significantly from that of the epilepsy group, and the authors compared it to drug-resistant epilepsy. Of 55 deaths, external causes contributed 18%; suicide accounted for 20% of deaths in people under 50; and "epilepsy" was recorded as the cause of death in 24%, despite the functional seizure diagnosis.
• Sweden. Zhang and colleagues used national registers to compare 885 people with functional seizures against 10 matched controls each. 3.6% of the people with functional seizures died, against 0.5% of controls, an adjusted hazard ratio of 5.5. The risk was raised for both natural causes (8.1) and non-natural causes such as suicide and injury (15.3), and suicide accounted for 18.8% of deaths. People with epilepsy had a 6.7-fold risk in the same study.

Both teams stated that the reasons are not fully understood. The Melbourne authors pointed to the importance of prompt diagnosis and of identifying risk factors; the Swedish authors called for further research into the high share of suicides.

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What Is Not Known

• Which treatment works best, and for whom. The guideline found only 12 qualifying studies, none at the highest class, and the largest trial missed its main seizure-frequency goal. The CODES authors called for work to identify who benefits most.
• Long-term effect of treatment. Most trials followed people for months to a year; the multi-year cohorts mostly predate modern treatment.
• Why death rates are raised. Both mortality studies found a higher risk without fully explaining it, including the role of suicide, other illnesses and missed epilepsy.
• The true numbers. Population figures come from a few regions, and the pooled figures for people with both functional seizures and epilepsy vary widely between studies.
• The cause. Post-traumatic stress disorder, anxiety, deprivation and other functional symptoms are common, but none is present in everyone, and how they lead to seizures is not settled.
• The name. There is still no single agreed name, and the seminar paper treats agreement as an open question.
• Children. The Norwegian study found the highest prevalence in teenagers, but most trials enrolled adults only.

Decisions about tests, medicines and treatment belong with a clinician who knows the person's history.

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Key Research Papers

1. Tolchin B, Goldstein LH, Reuber M, Stone J, Perez DL, LaFrance WC Jr, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. PubMed PMID: 41370742
2. Goldstein LH, Robinson EJ, Mellers JDC, Stone J, Carson A, Reuber M, et al. Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. Lancet Psychiatry. 2020;7(6):491-505. PubMed PMID: 32445688
3. LaFrance WC Jr, Baker GA, Duncan R, Goldstein LH, Reuber M. Minimum requirements for the diagnosis of psychogenic nonepileptic seizures: a staged approach: a report from the International League Against Epilepsy Nonepileptic Seizures Task Force. Epilepsia. 2013;54(11):2005-18. PubMed PMID: 24111933
4. LaFrance WC Jr, Baird GL, Barry JJ, Blum AS, Frank Webb A, Keitner GI, et al. Multicenter pilot treatment trial for psychogenic nonepileptic seizures: a randomized clinical trial. JAMA Psychiatry. 2014;71(9):997-1005. PubMed PMID: 24989152
5. Moro P, Lattanzi S, Beier CP, Di Bonaventura C, Cerulli Irelli E. Cognitive behavioral therapy in adults with functional seizures: A systematic review and meta-analysis of randomized controlled trials. Epilepsy Behav. 2024;159:109981. PubMed PMID: 39181107
6. Carlson P, Nicholson Perry K. Psychological interventions for psychogenic non-epileptic seizures: A meta-analysis. Seizure. 2017;45:142-150. PubMed PMID: 28063373
7. Reuber M, Fernández G, Bauer J, Helmstaedter C, Elger CE. Diagnostic delay in psychogenic nonepileptic seizures. Neurology. 2002;58(3):493-5. PubMed PMID: 11839862
8. Duncan R, Razvi S, Mulhern S. Newly presenting psychogenic nonepileptic seizures: incidence, population characteristics, and early outcome from a prospective audit of a first seizure clinic. Epilepsy Behav. 2011;20(2):308-11. PubMed PMID: 21195031
9. Villagrán A, Eldøen G, Duncan R, Aaberg KM, Hofoss D, Lossius MI. Incidence and prevalence of psychogenic nonepileptic seizures in a Norwegian county: A 10-year population-based study. Epilepsia. 2021;62(7):1528-1535. PubMed PMID: 34075579
10. Goldstein LH, Robinson EJ, Reuber M, Chalder T, Callaghan H, Eastwood C, et al. Characteristics of 698 patients with dissociative seizures: A UK multicenter study. Epilepsia. 2019;60(11):2182-2193. PubMed PMID: 31608436
11. Kutlubaev MA, Xu Y, Hackett ML, Stone J. Dual diagnosis of epilepsy and psychogenic nonepileptic seizures: Systematic review and meta-analysis of frequency, correlates, and outcomes. Epilepsy Behav. 2018;89:70-78. PubMed PMID: 30384103
12. Avbersek A, Sisodiya S. Does the primary literature provide support for clinical signs used to distinguish psychogenic nonepileptic seizures from epileptic seizures? J Neurol Neurosurg Psychiatry. 2010;81(7):719-25. PubMed PMID: 20581136
13. Benbadis SR, Tatum WO. Overintepretation of EEGs and misdiagnosis of epilepsy. J Clin Neurophysiol. 2003;20(1):42-4. PubMed PMID: 12684557
14. Benbadis SR. "Just like EKGs!" Should EEGs undergo a confirmatory interpretation by a clinical neurophysiologist? Neurology. 2013;80(1 Suppl 1):S47-51. PubMed PMID: 23267045
15. Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC Jr, Duckrow RB, et al. Assessment of the Predictive Value of Outpatient Smartphone Videos for Diagnosis of Epileptic Seizures. JAMA Neurol. 2020;77(5):593-600. PubMed PMID: 31961382
16. Jungilligens J, Michaelis R, Popkirov S. Misdiagnosis of prolonged psychogenic non-epileptic seizures as status epilepticus: epidemiology and associated risks. J Neurol Neurosurg Psychiatry. 2021;92(12):1341-1345. PubMed PMID: 34362852
17. Viarasilpa T, Panyavachiraporn N, Osman G, Kowalski RG, Miller J, Barkley GL, et al. Differentiation of psychogenic nonepileptic attacks from status epilepticus among patients intubated for convulsive activity. Epilepsy Behav. 2021;115:107679. PubMed PMID: 33360401
18. Hall-Patch L, Brown R, House A, Howlett S, Kemp S, Lawton G, et al. Acceptability and effectiveness of a strategy for the communication of the diagnosis of psychogenic nonepileptic seizures. Epilepsia. 2010;51(1):70-8. PubMed PMID: 19453708
19. Mayor R, Brown RJ, Cock H, House A, Howlett S, Singhal S, et al. Short-term outcome of psychogenic non-epileptic seizures after communication of the diagnosis. Epilepsy Behav. 2012;25(4):676-81. PubMed PMID: 23168089
20. Reuber M, Pukrop R, Bauer J, Helmstaedter C, Tessendorf N, Elger CE. Outcome in psychogenic nonepileptic seizures: 1 to 10-year follow-up in 164 patients. Ann Neurol. 2003;53(3):305-11. PubMed PMID: 12601698
21. Nightscales R, McCartney L, Auvrez C, Tao G, Barnard S, Malpas CB, et al. Mortality in patients with psychogenic nonepileptic seizures. Neurology. 2020;95(6):e643-e652. PubMed PMID: 32690794
22. Zhang L, Beghi E, Tomson T, Beghi M, Erba G, Chang Z. Mortality in patients with psychogenic non-epileptic seizures a population-based cohort study. J Neurol Neurosurg Psychiatry. 2022;93(4):379-385. PubMed PMID: 35086937
23. Nicholson D, Gaskell C, Rawlings GH, Gray C, Xue Q, Reuber M, et al. The prevalence of post-traumatic stress disorder in functional / dissociative seizures: A systematic review and meta-analysis. Seizure. 2026;141:223-232. PubMed PMID: 42541980
24. Asadi-Pooya AA, Brigo F, Mildon B, Nicholson TR. Terminology for psychogenic nonepileptic seizures: Making the case for "functional seizures". Epilepsy Behav. 2020;104(Pt A):106895. PubMed PMID: 31986440
25. Wardrope A, Dworetzky BA, Barkley GL, Baslet G, Buchhalter J, Doss J, et al. How to do things with words: Two seminars on the naming of functional (psychogenic, non-epileptic, dissociative, conversion, …) seizures. Seizure. 2021;93:102-110. PubMed PMID: 34740139
26. Scull DA. Pseudoseizures or non-epileptic seizures (NES); 15 synonyms. J Neurol Neurosurg Psychiatry. 1997;62(2):200. PubMed PMID: 9048729

PubMed Topic Searches

1. PubMed: functional seizures treatment trials
2. PubMed: video-EEG diagnosis of psychogenic non-epileptic seizures
3. PubMed: dissociative seizures outcome and follow-up
4. PubMed: functional seizures mistaken for status epilepticus

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Connections

• Conversion Disorder (Functional Neurological Symptom Disorder) — the parent page on the whole disorder
• Epilepsy — the condition functional seizures are most often mistaken for
• Psychiatry — the category hub
• Post-Traumatic Stress Disorder — found in about a third of people with functional seizures
• Anxiety — a common co-occurring condition
• Dissociative Identity Disorder — another condition built around dissociation
• Seizure and Epilepsy Animation — what an epileptic electrical discharge looks like
• Syncope — fainting, the other common seizure look-alike

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