Functional/dissociative seizures: Review of its relationship with trauma, dissociation and the neurobiological underpinnings

Abstract

Functional dissociative seizures (FDS) are paroxysmal and episodic events associated with motor, sensory, mental, or autonomic manifestations, which resemble epileptic seizures but are not caused by epileptogenic activity. FDSs affect approximately 30% of patients attending specialized epilepsy centers and constitute a severe mental health problem. Patients with FDSs also have a high frequency of other psychiatric comorbidities like depression and anxiety disorders, particularly trauma and post-traumatic stress disorder. It has been postulated that FDSs are essentially dissociations that operate as an evitative psychological mechanism to deal with traumas. In this manuscript, we carried out a state-of-the-art review to provide a critical approach to the extensive literature about FDS, focusing on the relationship with trauma, post-traumatic stress disorder, dissociation, and the neurobiology of these phenomena. • Functional/dissociative seizures (FDS) are commonly related to trauma and dissociation. • Trauma might play an etiological role in FDS, at least in some groups of patients. • Few authors studied the neurobiology of FDS, trauma and dissociation. • The neurobiological aspects of these health issues are still under discussion. • The over-modulation of the amygdala might explain the dissociation of these patients.