Breathing control training for functional seizures: A multi-site, open-label pilot study.

Area of Science:

• Neurology
• Psychiatry
• Respiratory Medicine

Background:

• Functional seizures (FS) lack well-validated treatments, with psychotherapy evidence being qualified and access limited.
• Hyperventilation is associated with functional seizures, suggesting respiratory interventions may be beneficial.

Purpose of the Study:

• To explore breathing control training as a novel treatment for functional seizures.
• To assess the feasibility, tolerability, and preliminary efficacy of breathing control training in adults with FS.

Main Methods:

• A multi-site, open-label pilot trial involving 18 adult participants with functional seizures.
• Participants received one hour of breathing control training from a respiratory physiotherapist, followed by a 30-minute booster session one month later.
• Seizure frequency and Nijmegen scores (hyperventilation measure) were assessed at baseline and 3-4 months post-intervention.

Main Results:

• Ten participants completed the follow-up assessment.
• Seven out of ten completers demonstrated improved seizure frequency (p=0.09).
• Seizure frequency significantly correlated with Nijmegen scores (Spearman's rho = 0.75, p=0.034), and the intervention was well-tolerated with no adverse events.

Conclusions:

• Breathing control training is a potentially effective, cost-effective, and acceptable new approach for managing functional seizures.
• These preliminary findings warrant confirmation through a randomized controlled trial to establish definitive efficacy.