Psychological Interventions May be Effective for Functional Seizures

MONDAY, Dec. 15, 2025 (HealthDay News) — Psychological interventions may be effective for achieving freedom from functional seizures, according to new practice guidelines issued by the American Academy of Neurology and published online Dec. 10 in Neurology.

Benjamin Tolchin, M.D., from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a systematic review and developed evidence-based recommendations for clinicians, patients, and other stakeholders on the management of functional seizures.

The researchers found that psychological interventions are possibly effective for increasing the likelihood of achieving freedom from functional seizures, reducing the frequency of functional seizures, reducing anxiety, and improving health-related quality of life and psychosocial functioning. They recommend that clinicians should seek historical and semiological information from both patients and witnesses when evaluating patients with seizure-like episodes, and where feasible, they may obtain video-electroencephalograms of all typical seizure-like episodes. Patients diagnosed with functional seizures should be evaluated for co-occurring psychiatric disorders and co-occurring epilepsy.

The researchers note that universal standards of care for patients should be adhered to, including speaking respectfully, refraining from unnecessary harm, and avoiding stigmatizing behavior. A specific diagnostic label and rationale for the diagnosis should be provided by clinicians; they should engage in shared decision-making regarding the treatment plan and should provide continuity of care. Clinicians should counsel patients regarding the potential benefits and risks of psychological interventions when they are indicated; interested and appropriate patients should be referred to these interventions. Patients with functional seizures without co-occurring epilepsy or another indication should not be prescribed benzodiazepines or antiseizure medications.

“Most people with functional seizures do not receive targeted and evidence-based treatment, contributing to ongoing functional seizures and disability,” Tolchin said in a statement.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text