FND Education Project

REFERENCE · RECOVERY TECHNIQUE

Individualized Episode Safety Plan for Functional Seizures

Most likely fit: Convulsive, still or unresponsive events, including episodes with no usable warning, where a consistent injury-prevention and emergency response is needed. [Clinical safety guidance; not a method for forcing an episode to stop]

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Plan while you are well enough to choose

A short written plan tells people how to protect you during your established events and when something needs medical help. Include your usual event types, who to contact, helpful positioning, known injuries or movement restrictions, and any separate epilepsy plan. [1][2]

Responsiveness means being able to respond; it does not reliably tell others everything you can hear or remember. Supporters should speak respectfully even when you cannot answer. The airway is the passage that lets air reach your lungs. Protecting breathing and avoiding injury take priority over an exercise.

At the start of a familiar episode

If there is time, stop the hazardous activity and use the safe position agreed with your team. If there is no warning, the plan must rely on the environment and nearby help. It must not depend on you catching every seizure early.

Afterward, wait until you are sufficiently alert and able to swallow safely before food or drink. You need not get up immediately. Agree in advance how someone should help if weakness, dizziness or confusion remains.

For a first event, serious injury, abnormal breathing, an event in water, or a substantially changed pattern, seek urgent help. A prolonged or repeated event without the usual recovery needs the agreed medical response; without a clear individualized plan, seek emergency advice rather than assuming it is safe.

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

Clear nearby hazards, protect the head with something soft when feasible, and time the episode. Do not hold the person down, force limbs straight, put anything in their mouth or use painful stimulation. Do not give food, drink or oral medication while awareness is impaired. [3]

Stay nearby and observe breathing. After convulsive movement stops, use side positioning when appropriate and safe under the plan or dispatcher’s advice; do not force a rigid body into position. Do not move someone with a suspected serious injury unless immediate danger requires it. If they are unresponsive and not breathing normally, call emergency services and follow dispatcher CPR instructions. An FND diagnosis does not change that response.

If epilepsy also occurs, follow the separate prescribed rescue plan for the identified epileptic event. Do not substitute general website advice for it.

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

Explicit procedure

  1. Document each established event’s appearance, usual duration, awareness, breathing observations, recovery and uncertainty.
  2. Assess falls, impact injuries, aspiration risk, pregnancy-related considerations and relevant musculoskeletal restrictions.
  3. Specify safe environmental arrangements and feasible positioning, including when movement should be avoided.
  4. State individualized emergency thresholds in plain language; distinguish familiar prolonged events from a new or uncertain prolonged event.
  5. If epilepsy coexists, identify which event requires prescribed rescue medication and how supporters should act when unsure.
  6. Rehearse the response verbally, without inducing a seizure, and give copies to the person and authorized supporters.
  7. Review after injury, a changed event or an emergency attendance.

Outcomes and limits

Track injury, response errors, avoidable escalation and missed escalation. Do not evaluate the supporter by whether the event stops. A plan cannot guarantee safety, establish diagnosis or justify withholding necessary emergency assessment. The general five-minute epilepsy emergency threshold must not simply be erased for a person whose event type is uncertain; clarify how local emergency guidance applies to their established events.

Basis and evidence boundary

The guideline supports accurate event classification and avoidance of inappropriate treatment. Practical first-aid wording is a conservative educational synthesis, requiring an individualized clinician-approved plan. [1][2]

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

General first-aid precautions are drawn from NHS guidance. Its emergency advice is adjacent safety guidance, not a functional-seizure treatment trial; an individualized event plan must address duration, uncertainty and coexisting epilepsy. [3]

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.
[2] Stone J. Treatment of Functional Seizures. Neurosymptoms. Specialist treatment overview. Accessed September 14, 2026. FND-CIT-0098.
[3] NHS. What to do if someone has a seizure (fit). General seizure first aid. Reviewed December 19, 2023; accessed September 14, 2026. FND-CIT-0101.

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 —