Neurology® Podcast Management of Functional Seizures Practice Guideline Executive Summary
Dec 25, 2025
Benjamin Tolchin, an Associate Professor of Neurology at Yale and director of the Centre for Clinical Ethics, and Jon Stone, a Professor of Neurology in Edinburgh, dive into the critical management of functional seizures. They discuss the rising need for clinical guidelines driven by increasing diagnosis rates. The duo emphasizes the importance of accurate diagnosis, recommending methods like semiology and interictal EEG. They explore the efficacy of psychological treatments and advocate for multidisciplinary care to enhance patient outcomes.
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Growing Recognition Enables New Guidelines
- Functional seizures are increasingly diagnosed due to video-EEG use and greater clinician awareness.
- Growing evidence and demand for guidance motivated the AAN practice guideline development.
Collect Semiology And Smartphone Videos
- Always collect detailed history and semiology and obtain collateral witness reports.
- Encourage patients to record smartphone videos of typical events when video-EEG isn't available.
Use EEG As Part Of The Puzzle
- Use routine interictal EEG alongside history and semiology to increase diagnostic certainty.
- Do not rely on a normal EEG alone to diagnose functional seizures; combine data sources.