Article Text

Download PDFPDF
Functional (psychogenic non-epileptic/dissociative) seizures: why and how?
  1. Deniz Ertan1,2,
  2. Selma Aybek3,4,
  3. W Curt LaFrance, Jr.5,
  4. Kousuke Kanemoto6,
  5. Alexis Tarrada7,8,
  6. Louis Maillard1,7,
  7. Wissam El-Hage9,
  8. Coraline Hingray7,8
  1. 1 CRAN,UMR7039, Centre de Recherche en Automatique de Nancy, Vandoeuvre les Nancy, Grand Est, France
  2. 2 Unité de recherche clinique, Établissement Médical de La Teppe, Tain-l'Hermitage, France
  3. 3 Department of Clinical Neuroscience, Hopitaux Universitaires de Geneve, Geneva, Switzerland
  4. 4 Department of Clinical Neuroscience, Inselspital Universitatsspital Bern Universitatsklinik fur Neurologie, Bern, Switzerland
  5. 5 Psychiatry and Neurology, Brown Medical School Rhode Island Hospital, Providence, Rhode Island, USA
  6. 6 Neuropsychiatric Department, Aichi Medical University, Nagakute, Aichi, Japan
  7. 7 Neurology Department, CHRU de Nancy, Nancy, Lorraine, France
  8. 8 University Psychiatry Department, Centre Psychothérapique de Nancy, Laxou, Lorraine, France
  9. 9 Department of Psychiatry, CHRU Tours, Tours, Centre, France
  1. Correspondence to Dr Coraline Hingray, Psychiatry department, Centre Psychothérapique de Nancy, 54520 Laxou, Lorraine, France; c.hingray{at}


Functional seizures (FS) known also as psychogenic non-epileptic seizures or dissociative seizures, present with ictal semiological manifestations, along with various comorbid neurological and psychological disorders. Terminology inconsistencies and discrepancies in nomenclatures of FS may reflect limitations in understanding the neuropsychiatric intricacies of this disorder. Psychological and neurobiological processes of FS are incompletely understood. Nevertheless, important advances have been made on underlying neuropsychopathophysiological mechanisms of FS. These advances provide valuable information about the underlying mechanisms of mind–body interactions. From this perspective, this narrative review summarises recent studies about aetiopathogenesis of FS at two levels: possible risk factors (why) and different aetiopathogenic models of FS (how). We divided possible risk factors for FS into three categories, namely neurobiological, psychological and cognitive risk factors. We also presented different models of FS based on psychological and neuroanatomical understanding, multilevel models and integrative understanding of FS. This work should help professionals to better understand current views on the multifactorial mechanisms involved in the development of FS. Shedding light on the different FS profiles in terms of aetiopathogenesis will help guide how best to direct therapy, based on these different underlying mechanisms.

  • epilepsy
  • conversion disorder
  • neuropsychiatry

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @ElHageWissam1

  • Contributors CH designed and directed the project on an original idea from SA. DE and CH wrote the manuscript. WCL, KK and SA reviewed, completed and corrected this manuscript with intercontinental point of view. AT, WEH and LM worked on illustrations and participated to the construction of this manuscript.

  • Funding This study was supported by French Ministry of Health, project EDUQ-CPNEand by Centre Médical de la Teppe

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.