Functional dissociative seizures: How do professionals in Buenos Aires, Argentina approach diagnosis and management?:...

Functional Dissociative Seizures (FDS), a subtype of Functional Neurological Disorders, are conditions originating from disruptions in nervous system function. Despite established diagnostic criteria, significant uncertainty persists among healthcare professionals regarding their diagnosis and management, particularly in low- and middle-income countries. This study examines how healthcare professionals in Buenos Aires, Argentina, perceive and approach FDS in clinical practice.

This cross-sectional, mixed-methods study recruited neurologists, primary care physicians, psychiatrists, and psychologists in Buenos Aires (2020-2023) through exponential snowball sampling. Participants completed an online instrument developed and expert-validated for this study, including a two-part clinical vignette. Quantitative data were analyzed descriptively, and qualitative responses underwent thematic analysis using Braun and Clarke's six steps.

A total of 38 healthcare professionals participated. Diagnostic patterns varied by profession, with neurologists and psychiatrists leaning toward FDS, while psychologists more often diagnosed epilepsy with psychiatric comorbidities. Diagnoses were mainly based on seizure characteristics and mental health symptoms. Professionals prioritized further information on patients' backgrounds and seizure features. Treatment plans focused on neurological testing and referrals to neurology and mental health services. Challenges included limited training and low perceived competence, especially among psychologists. After receiving more case details, several participants-primarily psychologists-revised their diagnosis from epilepsy to FDS; all professional groups prioritized further exploration of mental health symptoms and disorders.

This study highlights challenges in FDS diagnosis and management in Argentina, including limited training and poor interdisciplinary coordination. Improving education and collaboration are essential to enhance diagnosis, treatment, and outcomes.