Functional Seizures: The Patient’s Perspective of a Diagnostic and Treatment Odyssey

Authors

Heather J. Andrini, Chapman UniversityFollow
Sydni L. Au Hoy, Chapman UniversityFollow
Ashley M. Okhovat, Chapman UniversityFollow
Juliana Lockman, Stanford University
Gregory R. Goldsmith, Chapman UniversityFollow

Document Type

Article

Publication Date

11-26-2021

Abstract

Functional seizures can be challenging to properly diagnose, often leading to delays in treatment. The etiology of functional seizures is multifactorial, with psychological factors identified in many, but not all cases. Misdiagnosis may occur due to clinical features mimicking other medical conditions. Once a correct diagnosis is reached, delivery of definitive, evidence-based treatment may be challenging due to limited availability of specialized resources. Research shows psychological education and cognitive behavioral therapy (CBT) have the greatest efficacy. However, individual differences, including acceptance of the diagnosis, therapeutic alliance, duration of symptoms, comorbidities, and access to care may influence outcomes. There is a critical need for reports that can help identify barriers to effective diagnosis and treatment. We present the diagnosis and treatment of a woman who visited the emergency room after an attack of predominant left-sided paralysis, speech dysfunction and altered awareness. Following multiple daily episodes and visits to multiple medical practitioners, testing led to a diagnosis of functional seizures. While the patient was recommended to undergo a variety of therapeutic interventions, including CBT, she ultimately terminated treatment. In a subsequent interview, the patient revealed her personal experience with perceived limitations of acute management strategies. We explore the complexities of diagnosing and treating individuals with functional seizures.

Comments

This article was originally published in Epilepsy & Behavior Reports, volume 17, in 2022. https://doi.org/10.1016/j.ebr.2021.100509

Recommended Citation

Andrini HJ, Au Hoy SL, Okhovat AM, Lockman J, Goldsmith GR. Functional seizures: The patient's perspective of a diagnostic and treatment odyssey. Epilepsy Behav Rep. 2022;17:100509. https://doi.org/10.1016/j.ebr.2021.100509

Copyright

The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.