The therapeutic effect of breathing interventions for functional seizures: A scoping review

Functional/Dissociative Seizures (FDS) are presentations that appear like epileptic seizures but occur without abnormal cortical electrical activity in the brain. Abnormal respiratory patterns, particularly hyperventilation, have been frequently observed in people with FDS, suggesting this may be a potential therapeutic target. This scoping review aimed to explore the various applications of breathing techniques in the treatment of FDS, synthesizing evidence from clinical and case-based articles to provide a comprehensive overview of this therapeutic modality. Systematic searches were conducted in MEDLINE Complete, Embase, and PsycINFO databases to identify published case reports, case series, clinical trials, clinician perspectives, and book chapters reporting on the use of breathing as a primary or adjunct intervention in patients with diagnosed FDS. Of the 4123 articles identified, 28 were included in the final synthesis (18 = case reports/series; 10 = clinical trials). The majority of articles integrated breathwork within broader psychotherapeutic approaches, with only two using it as a standalone intervention. Findings provide preliminary support for the feasibility and potential benefit of breathing techniques in FDS management; however, the evidence remains limited, heterogeneous, and indirect. Further controlled studies are needed to clarify the mechanisms and efficacy of breathwork interventions for FDS.