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Behavioral Characterization of Pentylenetetrazole-induced Seizures: Moving Beyond the Racine Scale
Published on: July 8, 2025
Semiology of Functional Seizures: Sex-Related Differences
Ronen Spierer1, Lior Yavetz2, Moshe Herskovitz2,3
1Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel.
Brain and Behavior
|July 8, 2026
Summary
Functional seizures (FSs) present differently in men and women. Crying and pre-ictal freeze are more common in women, suggesting sex-related differences in trauma responses within the freeze-discharge framework of FSs.
Area of Science:
- Neurology
- Clinical Neuroscience
- Psychiatry
Background:
- Functional seizures (FSs) are more prevalent in women, yet distinct semiological characteristics between sexes remain underexplored.
- Previous research indicates limited sex-based differences in motor seizure semiology.
Purpose of the Study:
- To investigate and compare the motor semiological features of functional seizures between male and female patients.
- To identify potential sex-specific patterns in seizure manifestations.
Main Methods:
- A comparative study included 30 females and 28 males diagnosed with FSs via video-electroencephalogram.
- Semiology was categorized into generalized motor, subjective, and focal motor patterns.
- Specific features like limb/head/face/pelvic involvement, hyperventilation, crying, and pre-ictal freeze were analyzed for sex differences.
Main Results:
- No significant differences were observed in seizure duration, age at admission, or disease duration between sexes.
- Crying and pre-ictal freeze were found to be significantly more frequent in female patients.
- Other semiological features did not show significant sex-based variations.
Conclusions:
- Crying and pre-ictal freeze represent key semiological differences in functional seizures between women and men.
- These findings support the hypothesis of sex-related variations in trauma-related defensive responses, aligning with the freeze-discharge model of FSs.
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