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What are functional seizures? (Non-epileptic seizures)

Functional seizures are a type of functional neurological symptom. Many different words are used for functional seizures. The more commonly used terms include non-epileptic seizures, non-epileptic attack disorder (NEAD) non-epileptic events, dissociative seizures, pseudo seizures, pseudo-epileptic seizures, psychogenic seizures, or conversion seizures.

Some of these names can be offensive, none are perfect. Having so many different names for the same condition can be very confusing. However, all the names describe the same thing: attacks, which look similar to epileptic seizures, but are not caused by abnormal electrical activity in the brain (epileptic activity).

Functional seizures are experienced by around 2 or 3 people in every 10,000. This means that in a typical town with around 300,000 people (such as Cardiff, Wigan or Doncaster) there will be about 60-90 people who have functional seizures.

Of all the people who come into hospital with attacks, which do not settle quickly, nearly half turn out to have functional seizures.

About 1 in 6 people newly referred to specialist blackout clinics turn out to have functional seizures.

Symptoms of functional seizures

Functional seizures often look like epileptic attacks or fainting spells but there are often clues in the description such as:

  • Very frequent, prolonged attacks
  • Those in which the body movements come and go
  • Attacks where the person is emotionally upset afterwards

Like epileptic seizures, functional seizures can cause blacking out, collapsing, injuries and loss of bladder control. Functional seizures are not consciously produced to achieve something.

Better knowledge of functional seizures means they can now be identified more easily.

How are functional seizures diagnosed?

It is important to realise that the diagnosis of functional seizures and other seizure disorders is often a gradual process rather than a single event. The information available to the doctor about a first blackout is often limited. The diagnosis may become clearer as more events are observed and described. Most people with functional seizures are initially misdiagnosed as having epilepsy.

Specialists in treating functional seizures (such as neurologists) can sometimes tell what type of attacks you have when you or a witness describe the attacks in detail. Although functional seizures resemble epileptic seizures, there are small but important differences in how the person having attacks, or witnesses describe these.

Video recordings (for instance on a mobile phone) or photos of a typical attack can be very helpful to the doctor to make the correct diagnosis. Seizure experts can accurately diagnose nine out of ten seizures if they have access to a video recording of a seizure, or have observed a seizure.

Depending on the nature of your attacks, other tests can be helpful including brain scans, blood tests, and heart recordings. These tests may be carried out to look for other causes of blackouts. However in some cases no further investigations are necessary when a seizure expert has heard a description of your attacks.

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