FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Diagnostic Explanation and Continuing Care for Functional Seizures

Most likely fit: When the diagnosis is new, confusing, disputed or disconnected from a usable treatment and follow-up plan. [Clinical guideline recommendation; explanation alone is not an established seizure-stopping treatment]

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

Leave with an explanation you can use

Ask the clinician to describe the evidence for your event type, what the diagnosis explains, what remains uncertain and who will help next. A normal test on its own is not an adequate explanation. You can ask questions or request clarification without having your symptoms treated as a failure to accept FND. [1]

Functional seizures are involuntary episodes that may change movement, awareness or responsiveness. Video-EEG records behaviour and the brain’s electrical activity together. The clinician interprets those recordings in context; this is not something a person can diagnose from one normal EEG or a checklist. Epilepsy and functional seizures can occur in the same person.

An example appointment plan

Bring three questions on paper: “What showed this?”, “What should we do during each kind of event?” and “Who will follow up?” Ask for a short written explanation, especially if memory, fatigue or discussing symptoms makes the appointment difficult. A supporter may take notes with your permission. You do not have to demonstrate or provoke an episode to deserve care.

At a familiar warning during an appointment, pause the discussion and use your established safety plan. Return to the explanation later. Repeatedly describing distressing episodes is not a required exercise.

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

Help record the person’s questions and the clinician’s answers without speaking over them. Ask whether they want you present for all or part of the visit. “We have not understood this yet” is useful information for the clinician.

If symptoms begin, stop questioning and follow the episode plan. Later, help obtain the written summary or arrange another short appointment; do not test whether the person remembers enough to be “ready” for treatment.

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

For Clinicians and the Care Team

Assessment and terminology

Explain semiology—the observed sequence and features of the event—and the level of diagnostic certainty for every reported event type. Translate ictal as “during the event” and interictal as “between events.” An interictal EEG result is not equivalent to recording a typical attack. Consider other neurological, cardiovascular and medical explanations when appropriate.

Explicit procedure

  1. Ask what the person already understands and which concern matters most.
  2. Describe the positive clinical evidence in accessible language, including any recording and its limitations.
  3. Explain coexistence: identifying a functional event does not classify every future event.
  4. Invite the person to explain the plan back in their own words; present this as checking your explanation, not testing acceptance.
  5. Provide a written event response, referral destination, contact route and follow-up arrangement.
  6. Ask about reading, memory, sensory, language, transport and financial barriers; adapt the delivery.
  7. Review unanswered questions and treatment access at follow-up rather than discharging solely because events are functional.

Progression, limits and review

Move from explanation to one agreed practical goal when the person is ready. Shorten or split appointments if they worsen symptoms. Measure understanding of the plan, access to care and unresolved concerns; do not infer motivation from seizure frequency. A changed event pattern requires clinical reassessment rather than another persuasion session.

Basis and evidence boundary

The AAN guideline supports a clear rationale, shared decisions and continuity. The appointment sequence here is an original educational implementation example, not a validated intervention protocol. [1]

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

Citation Full citation and source
[1] Tolchin B, Goldstein LH, Reuber M, Stone J, Perez DL, LaFrance WC Jr, et al. Management of Functional Seizures Practice Guideline Executive Summary: Report of the AAN Guidelines Subcommittee. Neurology. 2026;106(1):e214466. https://doi.org/10.1212/WNL.0000000000214466 FND-CIT-0010.

Created September 14, 2026 · Neurology, relevant therapy, lived-experience, caregiver and accessibility review pending

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