Functional (psychogenic non-epileptic/dissociative) seizures: why and how?

Area of Science:

• Neuroscience
• Psychiatry
• Psychology

Background:

• Functional seizures (FS), also termed psychogenic non-epileptic seizures or dissociative seizures, present with complex ictal manifestations and comorbidities.
• Current understanding of FS neuropsychiatric intricacies is limited by inconsistent terminology and incomplete knowledge of psychological and neurobiological processes.
• Recent advances offer insights into the neuropsychopathophysiology of FS, highlighting mind-body interaction mechanisms.

Purpose of the Study:

• To review recent studies on the aetiopathogenesis of functional seizures.
• To explore potential risk factors (neurobiological, psychological, cognitive) and aetiopathogenic models of FS.
• To enhance professional understanding of the multifactorial mechanisms underlying FS development and guide therapeutic approaches.

Main Methods:

• Narrative review of recent literature on functional seizures.
• Categorization of risk factors into neurobiological, psychological, and cognitive domains.
• Presentation of various aetiopathogenic models, including psychological, neuroanatomical, multilevel, and integrative perspectives.

Main Results:

• Identified distinct categories of risk factors contributing to functional seizures.
• Outlined diverse aetiopathogenic models, from psychological to integrative understandings.
• Highlighted the complexity of mind-body interactions in the development of FS.

Conclusions:

• A comprehensive understanding of FS aetiopathogenesis requires considering neurobiological, psychological, and cognitive factors.
• Different FS profiles stem from multifactorial mechanisms, necessitating tailored therapeutic strategies.
• Further research into FS mechanisms will refine diagnostic and treatment approaches.