Finding Your Way Through the Reference Library

Editorial Audit 1 and Work evidence review: November 7, 2026 · Independent clinical review pending

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For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources

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For the Person With FND

Someone has actually described this!

Natalie is sitting in her favourite chair, her laptop resting on a cushion beside her.

She’s been thinking about something that has bothered her for years: the explanation she was given for her functional seizures.

When her symptoms first developed, a psychologist diagnosed her with conversion disorder. Natalie didn’t understand what that meant for the shaking, the periods when she couldn’t move or speak, or the gaps in her memory.

She went looking for answers online. Through FND forums and other websites, she discovered that conversion disorder is an older name for what’s now generally called functional neurological disorder (FND).

At least she had a name she could learn more about.

Natalie spoke with her family doctor, who arranged a referral to a neurologist. But the explanation she received left her with more questions. Her episodes were discussed as dissociative events and compared with panic attacks.

Natalie wasn’t sure what that meant. Were these different names for the same thing? Was the neurologist suggesting she was having ordinary panic attacks? And how had anyone determined what was happening during her seizures?

She didn’t necessarily know which questions to ask back then.

Since that time, she’s been following the lessons in this FND course. She’s learned about the nervous system, body signals, movement, attention and the different ways functional symptoms can appear.

She’s also learned that understanding FND can help people approach their experiences differently, even when their symptoms remain severe.

Now she wants to put that knowledge to use.

She opens the FND Reference Library, selects Functional Seizures, then opens the Understanding and Diagnosis page.

Near the beginning, she reads about episodes involving shaking, jerking, stillness or an inability to respond. Some people may hear what’s happening around them but be unable to answer. Others remember only parts of an episode.

Natalie pauses.

She’s experienced several of those things. In fact, some of the details are remarkably familiar.

Other people experience things like this?

She’s read personal accounts before, but now she’s seeing those experiences described in a medical reference about a recognized condition.

For a moment, Natalie feels a little less alone.

When a description feels familiar

Imagine living with something that’s difficult to explain. Perhaps you’ve never met anyone who experiences it quite the way you do, and even the people treating you seem to have trouble understanding it.

Then you read a description that sounds surprisingly familiar.

You may feel relieved, curious or even a little emotional. Natalie certainly does.

She knows that reading about an experience doesn’t establish its cause. Similar symptoms can occur with different medical conditions, and a website can’t make a diagnosis.

But she’s not trying to diagnose herself. She’s trying to make sense of a diagnosis she was given years ago.

She notices that the page doesn’t expect everyone with functional seizures to experience the same symptoms. Some episodes involve considerable movement, while others involve stillness or reduced responsiveness.

That helps Natalie understand how two seizures can look quite different and still be considered part of the same condition.

It also raises an interesting question.

If these experiences are recognized, what have clinicians learned about identifying them?

She keeps reading.

What did they mean by dissociative?

Natalie discovers that functional seizures have several names. Depending on the source, she may see functional seizures, dissociative seizures or the older term psychogenic nonepileptic seizures (PNES).

Now something from her neurology appointment makes more sense.

The neurologist may have been using dissociative as another term for functional seizures. That word doesn’t automatically mean an episode was caused by anxiety, trauma or an emotional experience.

But what about panic attacks?

Natalie has learned enough to recognize an important distinction.

Functional seizures and panic attacks aren’t simply two names for the same experience.

Some symptoms can overlap, and people can experience both conditions. But determining what happened during a particular episode requires an appropriate clinical assessment.

Natalie doesn’t know exactly what her neurologist intended by the comparison. Perhaps they were describing similarities, or perhaps they believed panic was involved in her episodes.

She’d like to understand.

And now she knows that asking for clarification isn’t the same as rejecting her diagnosis.

How do clinicians know?

The Functional Seizures diagnostic page explains that clinicians consider the whole episode, including how it begins, what happens during it and how the person recovers.

It also discusses how video recordings and, when appropriate, a test called video-EEG can help.

Video-EEG: A test that records the brain’s electrical activity while video records what is happening to the person. When a typical episode is captured, clinicians can examine the two recordings together.

Natalie finds that interesting. She’d always thought of an EEG as a test that either found epilepsy or came back normal.

But a normal routine EEG between episodes cannot, by itself, rule out epilepsy. Recording and examining a typical event can provide more useful evidence, although not everyone needs or can undergo the same investigations.

She also learns that functional seizures and epileptic seizures can coexist, which is one reason different kinds of episodes sometimes need separate assessment.

Natalie thinks about her own appointments.

She remembers being asked questions about her seizures, but she isn’t sure which findings led to the conclusions she was given.

Perhaps the clinicians had reasons they didn’t explain clearly. Perhaps further assessment would be appropriate. She can’t determine that from the website alone.

But she can ask.

“What findings support the diagnosis of functional seizures in my case? And how do those findings relate to the different episodes I experience?”

That’s a much more useful question than wondering whether someone simply decided her seizures were panic attacks.

The Reference Library hasn’t told Natalie what her clinicians found.

It’s helped her understand what kind of explanation she can reasonably ask them to provide.

Is there anything that might help?

Natalie returns to the Reference Library and opens Recovery Techniques for Functional Seizures.

This is the part she’s particularly interested in.

Her seizures have been severe for years. She’s learned ways to make her surroundings safer and has developed routines for managing everyday life, but she still hopes the seizures themselves might improve.

For a long time, she’d wondered whether their frequency and severity were simply how things would always be.

Now she finds information about different approaches to treatment and recovery.

The page discusses the importance of a clear diagnosis and continuing care. It introduces individualized safety planning, recognizing useful warnings when they exist, seizure-focused psychological treatments and approaches to making meaningful activities more accessible.

It also explains why other health problems, such as pain or disrupted sleep, deserve attention alongside the seizures.

Natalie hadn’t realized there were so many different areas of care to consider.

Some treatment programmes have been studied in clinical trials, while other approaches are supported mainly by professional guidance or developing research. Not every treatment has been shown to reduce seizure frequency, and an approach that helps one person may not help another.

She notices something else.

Some techniques depend on recognizing an early warning and having enough awareness to use a practised strategy. Natalie’s seizures sometimes begin without a warning she can use, so those approaches may not be practical for her.

But other parts of care could still be relevant, particularly because she lives alone and her seizures can leave her unable to move or respond.

She also wonders whether the psychological treatment mentioned on the page is what the neurologist had meant by panic attacks.

As she reads, she begins to appreciate another distinction.

A psychological treatment can be considered for functional seizures without assuming that the seizures are ordinary panic attacks or that the person has a particular emotional cause for them.

The suitability of any treatment depends on the person’s diagnosis, circumstances, preferences and the available evidence.

Natalie doesn’t have to choose an approach herself. Some interventions require professional assessment or supervision, and her continuing safety and support needs remain important.

But she has found possibilities she didn’t previously understand.

And those possibilities give her something worthwhile to discuss with her care team.

What does recovery mean for someone like Natalie?

Natalie thinks back to the afternoon Leah visited.

In Lesson 24, we saw how she’d learned to enjoy time with her friend even though her symptoms remained severe.

That was meaningful progress.

But it wasn’t the only kind of progress Natalie wanted.

She would also love to have fewer functional seizures, recover more easily afterward and feel more confident about managing everyday activities.

Reading about recovery techniques has reminded her that adaptation and symptom improvement aren’t opposing goals.

A person can make life more manageable now while also working toward changes in their symptoms or abilities.

And although FND can be long-lasting, the course of the condition isn’t identical for everyone. Some people experience substantial improvement, others improve in particular areas, and some continue to live with severe symptoms despite treatment.

No website can predict Natalie’s outcome.

But she no longer has to assume that because her seizures have been severe for several years, they must always remain exactly as they are today.

That possibility means something to her. It isn’t a promise, and it doesn’t make the difficulties disappear.

It gives her a reason to ask what options may still be worth considering.

From understanding to better care

Natalie looks again at the two Reference Library pages she’s been reading.

She started with questions about the explanations she’d been given years ago.

Now she understands that conversion disorder and FND refer to the same diagnostic tradition, and that dissociative seizures is another term used for functional seizures. She also understands why describing her episodes as panic attacks would need a more specific explanation.

She’s learned a little about how clinicians assess functional seizures and discovered several areas of treatment and recovery she could discuss.

Most importantly, she has a clearer idea of what she’d like from her care.

Her original diagnosis deserves an explanation she understands. Her severe symptoms deserve continuing attention, and her treatment plan should reflect the difficulties she actually experiences.

Natalie decides to ask her family doctor for help arranging a review of her seizure care.

She doesn’t need to arrive with a self-diagnosis or a long list of internet findings.

She could simply explain:

“I’ve been learning more about functional seizures. I understand that dissociative seizures is another name for them, but I’m still confused about how my episodes were assessed and why they were compared with panic attacks. Could we review the diagnosis and talk about what treatment or support might help me now?”

That conversation might clarify the evidence already available. It might identify a need for further assessment or a referral to someone with experience treating functional seizures.

It might also reveal useful options for ongoing care that Natalie hasn’t had an opportunity to consider.

She doesn’t know yet.

But she has a direction.

More than a collection of information

Natalie closes her laptop.

Her migraine still hurts, and she doesn’t know how much her seizures might improve.

But something about the afternoon has been encouraging.

She’s seen experiences like her own described in a way that makes them understandable. She’s learned more about the questions clinicians use to distinguish functional seizures from other conditions, and she’s discovered recovery approaches worth discussing with her care team.

For years, Natalie sometimes felt that receiving a diagnosis was the end of the conversation.

Now she sees that understanding a diagnosis can be the beginning of better conversations about care.

The lessons she’s been following have given her knowledge she didn’t have before. The Reference Library has shown her where she can explore that knowledge further when she has a particular question.

She doesn’t need to learn everything or try everything.

For now, she’s found something that matters to her.

And that’s enough.

Something to think about

Imagine reading a description of a functional symptom you’ve been diagnosed with and discovering that it describes an experience you’ve struggled to explain for years.

What might it mean to discover that this experience is recognized and that other people have reported something similar?

Perhaps it would help you feel less alone. Or perhaps it would give you a better understanding of the diagnosis you’ve been living with.

How might that feel?

Imagine learning that your symptoms have been described in medical research and that different treatment or rehabilitation approaches have been developed for them.

You might feel hopeful, cautious or even frustrated that you hadn’t heard about some of these possibilities before.

What difference might it make to feel more informed about your condition and more involved in decisions about your care?

One small step

If you’d like to understand one of your previously diagnosed FND symptoms better, you could visit the Reference Library.

Start with its Understanding and Diagnosis page. See whether the descriptions help you recognize your experience and learn how clinicians assess that particular presentation.

If you’d like to explore possibilities for improvement, follow the link to the matching Recovery Techniques page. You can bring a question about anything that interests you to the appropriate care professional.

Perhaps you want to understand what findings supported your diagnosis. Perhaps you’d like to know whether a treatment or rehabilitation approach might be suitable for you.

Or perhaps simply discovering that your experience is recognized and understood would be enough for today.

You don’t need to become an expert in FND to take a more informed part in your care.

Optional crossword

Revisit the lesson with a crossword. The easy edition includes a word bank.

Optional colouring activity

Open the Lesson 26 colouring PDF (new tab), or browse the colouring collection.

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For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources

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For Family, Friends, and Other Supporters

When someone is left to find their own answers

Leah has come over for another visit, and Natalie has her laptop sitting beside her chair. She’s been reading about functional seizures in the FND Reference Library, and there’s something she’d like to share.

“Remember how I told you the neurologist compared my seizures to panic attacks?”

Leah remembers. Natalie had mentioned it before, although neither of them understood exactly what the neurologist had meant.

“Well, I’ve learned that dissociative seizures is another name for functional seizures,” Natalie explains. “But panic attacks aren’t the same thing. I still don’t know whether the neurologist was comparing them or saying that’s what I was having.”

Leah thinks for a moment.

“So, were you able to work out whether they diagnosed you correctly?”

Natalie laughs.

“Oh, I don’t think I’d even know how to do that! It’s more that I’ve found the words to explain what confused me. And now I know what I want to ask my doctor.”

Natalie picks up her laptop and tries to find the paragraph she’d been reading. She opens one page, then another. After a few moments, she’s forgotten which part she wanted to show Leah.

“Oh, for goodness’ sake. I was just looking at it!”

Leah laughs gently. She’s seen Natalie lose her place in a conversation before, and there’s no reason to make a fuss about this either.

“Would you like me to help you find it?”

“Yes, please. I think it was near the part about recording seizures.”

Together, they find the Functional Seizures diagnostic page. Leah reads a short passage aloud while Natalie follows along.

Natalie recognizes what she was looking for. The page explains how clinicians consider what happens during an episode, including changes in movement, awareness and recovery. It also describes how recordings and other clinical information can sometimes help establish a diagnosis.

“That’s it,” Natalie says. “I want to know which findings supported my diagnosis.”

Leah looks at the page again. She’s beginning to understand what Natalie has been trying to accomplish. Her friend isn’t looking for a website to decide whether the neurologist was right or wrong. She wants to understand what the earlier assessment established and how that relates to her own experiences.

Natalie has found information that helps her understand a diagnosis she’s already been given, and she’s beginning to recognize which questions belong with her care team.

And Leah hasn’t needed to become an expert. She’s helped Natalie find a paragraph and listened while she worked out what she wanted to ask.

But consider how much of that effort Natalie has already managed during the hours Leah wasn’t there.

The work behind finding an answer

Imagine someone with FND who wants to understand an explanation they were given several years ago.

Perhaps a clinician used an unfamiliar term during an appointment. The person remembers the term, or something that sounds like it, but not the explanation that followed.

They decide to look it up.

At first, it seems simple enough. They search for the term and find several pages discussing FND. Some use different names for the same condition. Others describe symptoms that sound familiar but don’t quite match their own experiences.

They open another page to understand a word they don’t recognize. Then another to learn about a treatment that’s mentioned.

Before long, they’ve got several pages open and can’t remember which question they were trying to answer.

Perhaps you’ve experienced something like that yourself, even without cognitive difficulties. You look up one thing, follow a few interesting links, and half an hour later you’re wondering how you ended up reading about something entirely different.

Now imagine trying to follow those links while managing a continuous migraine, difficulties concentrating and unreliable memory.

The person reads a paragraph, then realizes they haven’t understood it. They read it again. A few sentences make sense, but by the end they’ve lost track of the beginning.

They may find themselves going over the same information several times.

Eventually, they put the device down because their head hurts and they’re exhausted.

They still have the question they started with.

And tomorrow, when they return to the page, they may have difficulty remembering what they’d already learned.

This isn’t necessarily a lack of interest or ability to understand. The effort required to read, organize and remember information can become a considerable task in its own right.

Someone with a dependable supporter may be able to share some of that work. Another person might read a passage aloud, help find the page again or remember a question the person wanted to ask.

But what happens when there is nobody available?

The person may have to do the reading, remember the explanation, organize the questions and arrange the medical follow-up entirely on their own.

Memory isn’t always the difficulty, either. Someone may understand and remember information perfectly well but find that reading from a screen aggravates their migraine or light sensitivity. Another person might struggle with spoken explanations because of noise sensitivity or have speech difficulties that make phoning for clarification exhausting. For others, fatigue or persistent pain may limit how long they can comfortably concentrate on reading. The desire to understand is there, but the usual ways of obtaining information don’t always fit their needs.

And all of that happens alongside the ordinary responsibilities of daily life.

A diagnosis should come with an explanation

There’s another side to this worth considering.

Sometimes people are searching for information because the explanations they originally received were difficult to understand, incomplete or simply hard to remember.

One community member described how little guidance followed a loved one’s FND diagnosis:

“My partner has an FND diagnosis. He was basically told “you’ve got FND, go look it up.””

Figure 1 — Community experience: person describing a loved one’s diagnosis in an FND discussion. The wider discussion concerns swallowing difficulties; the quotation illustrates difficulty obtaining understandable guidance, not the cause of those symptoms. [4]

Imagine receiving a diagnosis for symptoms that have dramatically changed your life, then being left to work out what the diagnosis means.

Perhaps you have difficulties walking, episodes when you can’t respond or problems with memory. You’re trying to understand why these things happen and whether anything might help.

You search online and discover that different websites use unfamiliar terminology. Some explanations seem helpful, while others leave you with even more questions.

What are you supposed to make of all that?

A supporter may feel tempted to take over the research, especially when they can see how much difficulty the person is having. They might find several articles, print information or begin recommending possible treatments.

Those efforts may come from a place of genuine care.

But the person with FND may not want every article or every possible treatment. They may have one particular question that matters to them, and they deserve to decide where the conversation begins.

Natalie, for example, isn’t looking for someone to choose a treatment on her behalf. She wants to understand why her seizures were diagnosed the way they were and what care might still help her.

That’s where the Reference Library can be useful. Its pages bring together descriptions, research and treatment information, while explaining important limitations. But the library can’t know which findings were recorded during Natalie’s appointments or which treatments are appropriate for her.

Those questions still belong in a conversation with her care team.

And the responsibility for providing a clear medical explanation shouldn’t fall entirely on Natalie simply because she’s willing to learn.

Research supports taking diagnostic communication seriously. A 2026 review examined 15 studies concerning how people understand and respond to an FND diagnosis. The findings highlighted the importance of explanations and follow-up, although the studies were too varied to establish that one particular way of explaining FND improves recovery. Read the research. [5]

The lesson for supporters is a fairly human one: someone may need help understanding what they’ve been told, without needing another person to decide what they should believe or do.

And when there’s no supporter, accessible explanations from healthcare professionals become even more important.

When nobody is there to help carry the information

Think about someone who attends an appointment alone.

They’ve spent the morning getting ready, arranging transportation and managing their symptoms. By the time they reach the examination room, they’re already tired.

The clinician explains something about their condition. It makes sense while they’re listening, and they have a question they’d like to ask. But before they can bring the words together, the conversation moves on. They try to remember the question while listening to the next explanation, and soon they’re struggling to hold both things in mind.

At the end of the appointment, they thank the clinician and make their way home. Later, sitting in their familiar chair, they remember that there was something important they wanted to ask, but the question itself won’t come back. They can remember parts of the conversation, just not enough to reconstruct everything.

Perhaps you’ve experienced that yourself after an ordinary medical appointment. It’s surprisingly easy to leave a consultation and remember the question you meant to ask only once you’re back in the car. For someone with cognitive difficulties, the problem may be much more persistent.

A supporter who attends with the person’s agreement might help remember a question or listen to an explanation. But they can forget things too, and not everyone wants another person present during private medical conversations.

And someone who has no dependable supporter cannot simply arrange for another person to attend.

This is where the way information is provided can make a real difference.

Imagine our person asking the clinician to write down the main explanation and the next step. Perhaps the clinic can provide a short written summary or information in a format the person finds easier to use.

They may still need to read it more than once, but at least the explanation is there when they return to it.

That won’t solve every problem with memory or concentration. Nor will every clinic have the same resources.

But it means the person doesn’t have to rely entirely on remembering a conversation that took place during an already demanding day.

And perhaps, when they return to the Reference Library later, they can begin with a clearer understanding of what they want to learn.

The difference between learning and carrying everything alone

Let’s return to Natalie and Leah.

Leah has finished reading the paragraph aloud, and Natalie has written a short question on a piece of paper.

“What findings supported my functional-seizure diagnosis?”

She also wants to ask whether there are treatments or other forms of care worth considering now, particularly because her seizures remain severe and sometimes begin without a warning she can use.

Leah asks whether she’d like help finding that information in the library.

Natalie thinks for a moment.

“Actually, I’ve already found the Recovery Techniques page. There are a few things I’d like to ask the doctor about. I just don’t want to spend the whole afternoon reading about seizures.”

“Fair enough,” Leah says. “I brought coffee, not homework.”

They put the laptop away.

Natalie still has questions, but she doesn’t need to answer them all today. She’s found information that’s helped her understand what she wants to discuss with her care team, and that’s enough for now.

Now imagine someone who has no Leah.

They may have to find the pages, understand the unfamiliar words and organize their own questions. If they become confused or exhausted, there may be nobody to help them pick up where they left off.

They might also be managing difficulties that make reading online impractical on some days, or they may not have dependable access to suitable technology.

It’s important that we don’t turn independence into another expectation someone must struggle to meet.

A person shouldn’t need to become an expert in FND to receive appropriate care, and having no personal supporter shouldn’t mean they’re expected to manage every healthcare responsibility without assistance.

Depending on what’s available, accessible written information, professional follow-up or help navigating services may reduce some of that burden. Some people may find community organizations or peer connections useful as well, although those aren’t substitutes for individualized medical assessment and care.

Such options aren’t available equally everywhere, and obtaining them may present difficulties of its own.

But recognizing the difference between someone’s willingness to learn and the amount of work they’re being left to do can change how we understand their needs.

A question worth asking

Imagine our person returning to a medical appointment with a small piece of paper.

They’ve managed to find an explanation they understand a little better. They still have questions, and some of the reading has been difficult, but they’ve worked out what matters most to them.

The note contains one question about their diagnosis and another about what help might be available.

Perhaps the clinician can explain the findings that supported the original diagnosis. Perhaps there are gaps in the old records, or a question that needs further consideration.

The person may leave with a clearer explanation, a plan for follow-up or written information they can return to when their memory is unreliable.

Not every appointment will go that well, and not every question will have an immediate answer. Some people will continue to encounter barriers to care even when they know exactly what they want to ask.

But there’s something hopeful about the possibility of being able to understand a little more without having to carry the entire responsibility for finding answers.

Natalie’s experience shows how learning can change a conversation. She began with several confusing terms and an old explanation that didn’t make sense to her. Now she has a clearer understanding of what those terms mean and a question her clinician can help her explore.

Someone without Leah may have a harder journey toward that same conversation. They may need information presented differently, more time to understand it or assistance that isn’t currently available.

Yet the goal remains worthwhile.

A person doesn’t have to solve every question about their condition before they can take part in decisions about their care.

There’s another difficulty we should acknowledge. Someone might read about a promising recovery technique, only to discover that nobody in their area has the training to provide it. There may be no local FND specialist, and travelling to another community may be beyond what they can manage. Remote appointments are sometimes possible, but not every treatment can be delivered remotely, and access is far from guaranteed. Imagine finally understanding that there may be an approach worth trying, then discovering there’s nobody available to help you pursue it. That’s a real disappointment. The Reference Library can help someone understand the possibilities and ask informed questions, but reading about a specialized treatment doesn’t make it available or turn it into something they should attempt without appropriate guidance.

And while we’ve spent much of these lessons considering people without dependable support, there’s one other relationship difficulty worth mentioning. Sometimes a spouse or close friend wants something different for the person with FND than the person wants for themselves. Imagine someone who’s eager to help Natalie tolerate sunlight again. They remember how much she used to enjoy being outdoors, and they would love to see her return to those activities. Natalie understands their hope, but what matters most to her right now is reducing the severity or frequency of her functional seizures. Neither wish is unreasonable. The difficulty begins when the supporter’s preferred goal becomes the one everyone works toward, while Natalie’s own priority receives less attention. The person living with the condition should have a meaningful say in what improvement would make the greatest difference to their life, while supporters can be honest about what assistance they’re able to provide.

Perhaps that’s one of the most useful things these lessons can leave us with. Better information doesn’t guarantee an available specialist, an effective treatment or agreement between everyone involved. But it can help people describe what they’re experiencing, understand the choices that may exist and explain what matters most to them. Whether someone has a devoted caregiver, an occasional friend or nobody dependable at all, their own priorities deserve to be heard.

Sometimes the next useful step is simply having one question understood, one explanation made clearer or one possibility for care brought into view.

For someone who’s spent a long time trying to make sense of their experiences alone, that can be a meaningful beginning.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources

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For Clinicians and the Care Team

When a diagnosis has several names

In the For the Person With FND section, Natalie uses the FND Reference Library to better understand her functional seizures. This clinical discussion can also be read independently.

Natalie lives alone with longstanding, severe FND. Her functional seizures sometimes involve shaking or jerking, while others leave her nearly motionless and unable to respond. Her awareness and memory of these episodes vary, and recovery can be prolonged.

None of her current clinicians participated in her original diagnosis or early treatment.

Years earlier, a psychologist diagnosed Natalie with conversion disorder. She subsequently encountered the term psychogenic episodes in her medical history. Later, a neurologist described her events as dissociative and compared them with panic attacks.

Natalie learned through online forums and other resources that conversion disorder is an older term associated with what is now generally called functional neurological disorder.

But the different explanations have left their mark.

When she first encountered psychogenic episodes, she understood the term as suggesting that her mind was somehow producing the attacks. She struggled to reconcile that explanation with experiences she couldn’t control.

Now, after following an FND education course, she has a question for her current clinician.

“I understand that my seizures have different names, but were they all describing the same condition? And how did anyone establish that they weren’t something else?”

Her question raises two related clinical issues: what the historical terminology meant, and what evidence supported the diagnosis.

When terminology shapes understanding

The terminology surrounding functional seizures has changed over time, reflecting developments in both clinical understanding and professional preferences.

Conversion disorder has a long diagnostic history. Psychogenic nonepileptic seizures (PNES) became widely used to describe seizure-like events not attributed to epileptic activity, while dissociative seizures has been common in other clinical traditions.

More recently, functional seizures has increasingly been used, emphasizing the neurological presentation without assuming a specific psychological cause.

Hingray and colleagues (2025), writing for an International League Against Epilepsy task force, proposed the term functional/dissociative seizures. Their publication contributes to the discussion of terminology and definition; it is not evidence that one particular psychological mechanism explains every patient’s episodes. [2]

These differences in language matter because terminology carries meaning beyond its formal definition.

For example, psychogenic historically suggested psychological origins. A clinician using the term may have been working within the accepted diagnostic language of the time, without intending to suggest that the symptoms were fabricated or voluntarily produced.

Yet a patient might understand it very differently.

Natalie interpreted the phrase as suggesting personal responsibility for attacks that felt entirely outside her control.

That interpretation influenced how she understood her condition, even if it wasn’t what the earlier clinician intended to communicate.

The terminology itself doesn’t establish that the original diagnosis was incorrect.

But it helps explain why Natalie may have difficulty connecting the diagnosis she received with the neurological explanations and recovery information she’s now encountering.

What about panic attacks?

Natalie’s older neurology appointment introduced another uncertainty.

Her functional seizures were compared with panic attacks, but she isn’t sure whether the neurologist was describing a resemblance or proposing that panic was responsible for her episodes.

The distinction is clinically significant.

Functional seizures and panic attacks can share features, and both conditions may occur in the same person. But panic attacks are not simply another name for functional seizures.

Likewise, calling an episode dissociative doesn’t establish that anxiety, trauma or another emotional experience caused it.

The clinical significance depends on what was actually assessed and how the findings were interpreted.

Natalie experiences different kinds of episodes. Some involve considerable movement; others involve stillness, reduced responsiveness or incomplete recall.

Those descriptions are important, but none establishes a diagnosis by itself.

The 2026 American Academy of Neurology functional-seizure guideline addresses diagnostic evaluation, communication, coexisting conditions and continuing care. Its recommendations recognize the importance of distinguishing functional seizures from other episodic conditions, including possible coexisting epilepsy. [1]

For Natalie’s current clinician, this raises a more specific question than whether the old terminology was appropriate:

What did the earlier assessments establish about her different episodes, and how confidently can those conclusions be understood today?

An inherited diagnosis and its evidence

Natalie’s current clinician has a historical diagnosis, her account of the earlier consultations and whatever examination or investigation records remain available.

These are different sources of information.

An earlier clinical conclusion may have been supported by appropriate findings, even if Natalie doesn’t remember the explanation. Conversely, the presence of a diagnosis in the medical history doesn’t reveal the evidence behind it.

The distinction is particularly relevant to functional seizures because diagnostic confidence depends on the available clinical information and the type of episode being considered.

For example, a typical event recorded with video-EEG may provide evidence that a routine EEG performed between episodes cannot. An event’s observed features and recovery may also contribute meaningful information, interpreted within the complete clinical picture.

Neither an unfamiliar description nor a normal routine EEG alone establishes functional seizures.

This doesn’t mean Natalie’s current clinician must repeat every earlier investigation or assume that the original work was inadequate.

The clinical question is what can reasonably be concluded from the evidence that exists.

If the historical assessment supports the established diagnosis, that reasoning may be explained more clearly now. If important details remain unavailable or the different episodes weren’t adequately characterized, the level of uncertainty may need to be acknowledged.

Either way, Natalie can gain something valuable: a better understanding of which conclusions are supported and why.

From understanding the diagnosis to understanding care

Natalie has another question.

She’s discovered the Functional Seizures Recovery Techniques page and was surprised by the range of treatment and support approaches described.

She had previously understood her seizures mainly in terms of psychological explanations and managing the consequences of unpredictable episodes.

Now she’s wondering whether there are treatment possibilities she hasn’t discussed with her current team.

This creates another useful distinction.

A treatment approach doesn’t necessarily establish the cause of the condition it is intended to help.

Psychological interventions can be relevant to functional seizures without demonstrating that panic, trauma or emotional distress caused a particular person’s episodes.

The evidence for those interventions also deserves careful interpretation.

Goldstein and colleagues (2020), in the multicentre randomized CODES trial, examined cognitive behavioural therapy specifically adapted for dissociative seizures alongside standardized medical care.

The study did not find a statistically significant improvement in its primary outcome of seizure frequency at 12 months, although several secondary outcomes favoured the CBT group. [3]

That distinction is important.

The trial doesn’t support promising every patient a reduction in seizures through CBT. It does, however, provide evidence about other possible treatment benefits, while leaving questions about individual response and which elements contribute to particular improvements.

The AAN guideline brings together the broader evidence on functional-seizure care, but guideline recommendations and research findings still require interpretation in the context of the person receiving care.

Natalie’s situation makes that especially relevant.

Her seizures are severe, and she sometimes has no warning she can use. She lives alone and can remain unable to move or respond during an episode.

An approach that relies on recognizing an early warning may offer limited practical value for her. Other aspects of care, including continuing diagnostic communication, appropriate treatment, safety and support, may remain relevant.

The question isn’t which technique every person with functional seizures should receive.

It’s which possibilities are supported by the evidence and meaningful for Natalie’s particular needs and goals.

What the Reference Library contributes

Natalie’s journey through the Reference Library illustrates an opportunity for more informed conversations about established diagnoses.

The Functional Seizures diagnostic page helps her recognize experiences resembling her own and understand the kinds of evidence clinicians consider.

The matching Recovery Techniques page introduces approaches to treatment, safety and participation, including their limitations.

These pages cannot establish the diagnosis or select treatment on Natalie’s behalf. They are educational resources, with ongoing human and clinical review, rather than validated clinical decision-support tools.

Their value lies in helping her ask better questions.

Natalie no longer needs to approach an appointment wondering vaguely whether her seizures are psychological, neurological or somehow her responsibility.

Instead, she can ask what findings support her diagnosis, how the historical terminology relates to her current understanding, and which treatment or support possibilities might be worth discussing.

This doesn’t transfer clinical responsibility to the patient.

It helps Natalie participate in a conversation that previously felt difficult to understand.

When understanding opens new possibilities

Consider how Natalie’s next appointment might differ from her earlier experiences.

She doesn’t need to dispute the diagnosis established years ago. Nor does her current clinician need to assume that an earlier professional made a mistake.

There is room to clarify what the existing evidence supports, acknowledge what remains uncertain and explain how functional seizures are understood within current clinical practice.

That discussion can also return to Natalie’s priorities.

She would like fewer seizures, more manageable recovery periods and greater confidence in participating in everyday life. She also needs her continuing safety and support requirements to be understood.

These goals aren’t interchangeable, and none is made irrelevant by the severity or duration of her condition.

If an explanation helps Natalie understand why her seizures are considered functional, that is a meaningful gain in understanding. If she subsequently considers a suitable treatment, its benefits and limitations can be discussed without suggesting that the treatment choice proves a psychological cause.

And if some symptoms remain severe despite treatment, that doesn’t make the original discussion or attempts to improve care meaningless.

A diagnosis that remains useful

Natalie’s story isn’t primarily about changing a diagnosis.

It’s about making an existing diagnosis more understandable and useful after years of different explanations.

The historical terminology may have reflected accepted practice, the interpretation of the evidence available at the time or distinctions that were never communicated clearly to Natalie.

Her current clinician has an opportunity to understand that history without assuming that every earlier conclusion was either correct or mistaken.

Research can clarify how terminology, diagnostic reasoning and treatment evidence have developed. The patient’s questions reveal which parts of that knowledge have not yet become meaningful to them.

For Natalie, recognizing herself in the medical literature may reduce her sense of isolation. Understanding the evidence behind her diagnosis may help her make sense of experiences she once found confusing. Learning about possible approaches to care may also give her more realistic hope.

The clinical value of a diagnosis extends beyond naming a condition. It also lies in helping the person understand what has been established, what that means for their experiences, and what possibilities remain for their care.

For a clinician inheriting a complex FND history, that understanding can be an important part of continuity—not because every previous explanation needs replacing, but because the patient deserves an explanation that remains useful today.

For the Person With FND
For Family, Friends, and Other Supporters
For Clinicians and the Care Team
Research and Sources

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Research and Sources

Research sources are identified by their evidence type and scope. The references below were checked against accessible original publications or their abstracts on November 7, 2026; access limits are recorded in the internal Work audit. Independent clinical review remains pending. Community quotations describe individual experiences and are not clinical or prevalence evidence. The stories and conversations in this lesson are fictional teaching examples, not research cases or tested treatment protocols.

Citation	Figure	Full citation and relevant use
[1]	—	Tolchin B, Goldstein LH, Reuber M, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. Original · FND-CIT-0010. Evidence-based guideline on functional seizure assessment, communication and care; not a universal algorithm.
[2]	—	Hingray C, Popkirov S, Kozlowska K, et al.; ILAE Functional/Dissociative Seizures Task Force. Functional/dissociative seizures: Proposal for a new diagnostic label and definition by the ILAE task force. Epilepsia. 2025;66(11):4162–4182. Original · FND-CIT-0009. Task-force terminology proposal, not proof of a universal psychological cause.
[3]	—	Goldstein LH, Robinson EJ, Mellers JDC, et al.; CODES study group. Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. The Lancet Psychiatry. 2020;7(6):491–505. Original · FND-CIT-0033. Mixed outcomes: primary 12-month seizure-frequency result and several secondary outcomes must be distinguished. Secondary outcomes were tested without adjustment for multiple comparisons.
[4]	Figure 1	Community quotation Q007 / source S03, r/FND discussion Choking Hazard, written by a partner about someone with FND. Original discussion · FND-CIT-0331. Exact opening wording, partner perspective and surrounding context independently rechecked November 7, 2026. Quotation concerns access to explanation, not the medical cause of swallowing symptoms.
[5]	—	Silva AF, Silva B. Diagnostic communication in functional neurological disorder: a systematic review and meta-analysis of patient acceptance and clinical outcomes. Patient Education and Counseling. 2026;152:109826. Original · FND-CIT-0083. Heterogeneous studies with limited comparative evidence; not proof that any particular explanation improves recovery.

Editorial Audit 1 and owner-approved Work corrections: November 7, 2026. Evidence access limits and validation results are recorded in the internal audit. Publication-readiness review completed November 8, 2026; independent clinical review and the project lead’s publication decision remain pending.