Functional seizures, previously known as Non-Epileptic Attack Disorder (NEAD), are a type of seizure that closely resemble epilepsy but are not caused by abnormal electrical activity in the brain. Instead, they are the result of changes in how the brain functions, particularly how signals are processed and controlled within the nervous system. Whilst the seizures can be just as distressing or disabling as epileptic seizures, they arise from changes in how the brain functions rather than abnormal electrical activity in the brain.

It’s also possible for someone to experience both epileptic and functional seizures, which is why an accurate, thorough diagnosis by a specialist is essential.

What Causes Functional Seizures?

There is currently no known single cause of functional seizures. They are best understood as a problem in how the brain is functioning. For some people, seizures may begin after a significant life event such as bereavement, an illness, a medical procedure, or an accident. For others, they may emerge during periods of prolonged stress, or for no clear reason at all.

Many people feel confused by the diagnosis, particularly if they do not feel overly anxious, and especially as seizures often occur during rest or sleep. This can lead to feelings of guilt or misunderstanding, but it is important to know these seizures are not imagined, exaggerated, or under conscious control.

What Can Trigger a Seizure?

Functional seizures can sometimes be triggered by a range of internal or external factors, although this is not always the case.

Triggers vary from person to person and may include emotional stress, sensory input such as bright lights, noise or heat, fatigue, illness, or feeling overwhelmed. Some people also experience seizures without any clear trigger.

Triggers are not the cause of the condition itself, but factors that may influence how the brain responds in a given moment.

Recognising patterns, where possible, can help some people manage their symptoms, but not all seizures can be predicted or prevented.

Not Under Conscious Control

Functional seizures are not something a person can control. Suggestions that they are being put on or are a performance are not only incorrect but deeply harmful.

During a seizure, the brain is responding to internal signals, and the person cannot influence how their body behaves. After a seizure, people often feel exhausted or confused and need time to rest. Stressful environments, particularly when surrounded by strangers or faced with judgement, can worsen episodes or delay recovery.

Barriers in Everyday Life

Going out in public: Many people with functional seizures feel anxious or unsafe in public spaces. Fear of having a seizure in front of others, being misunderstood, or judged can lead to withdrawal and isolation.

Risk of injury: Functional seizures can involve sudden collapses or loss of awareness, which may lead to injuries such as cuts, bruises, or broken bones. This can make everyday activities more hazardous and unpredictable.

Accessing services: Some institutions and workplaces still fail to make reasonable adjustments, as required under the Equality Act 2010, which can limit independence and access to support.

Other Symptoms and Comorbidities

Functional seizures may occur alongside other FND symptoms, such as motor difficulties, sensory disturbances, or problems with speech and cognition.

In addition, FND is not a catch-all diagnosis. People may also have other medical conditions which need to be carefully assessed and managed as part of the overall picture.

Diagnosis of Functional Seizures

A diagnosis should be made by a neurologist or within an epilepsy clinic, ideally through clinical observation or video EEG, identifying positive clinical features of functional seizures, not just by excluding epilepsy.

Capturing a seizure on video can be extremely helpful, as seizures do not usually occur on cue during clinical appointments. Video footage allows clinicians to observe key features and supports a more accurate diagnosis. Guidance on how to do this safely can be found here: How to video a seizure – FND Action

Treatment and Recovery

With the right support, some people may see a reduction in seizure frequency and severity.

Treatment approaches may include:

• Physiotherapy or occupational therapy where appropriate.

• Identifying potential triggers and working through responses to them.

• Psychological therapy, such as CBT or trauma-informed support where relevant.

• Grounding techniques and breathing exercises.

At the heart of recovery is collaborative, compassionate care. FND Action advocate for care that is timely, accessible, and person-centred.

Useful Resources

🟪 Seizure Medical Alert Card – from FND Action

📹 How to Video a Seizure – Guidance from FND Action

🚗 Driving rules – Epilepsy and Dissociative Seizures (GOV.UK)

🌻 Hidden Disabilities Lanyard – FND Action is part of the Sunflower Scheme. Available via our shop