Dissociative Seizures: 11 Crucial Facts for Recovery

Dissociative seizures, now often called functional seizures, are real episodes that can look and feel like epileptic seizures.

A person may shake, fall, stare, become unresponsive, or lose control of their body. The main difference is that functional seizures are not caused by the abnormal electrical brain activity that defines epilepsy.

They are a type of functional neurological disorder, or FND. This means there is a problem with how brain networks are functioning rather than a structural injury that explains the attacks.

The symptoms are involuntary. The person is not pretending, acting, or choosing to have them.

This article is for general information and education. It does not replace medical advice, diagnosis, or treatment.

Dissociative Seizures: Quick Answer

Dissociative seizures are episodes in which a person loses normal control of movement, awareness, sensation, or responsiveness.

They can include:

• Shaking
• Jerking
• Falling
• Staring
• Becoming motionless
• Becoming unresponsive
• Feeling detached or unreal

They may strongly resemble epilepsy, yet the mechanism is different.

Epileptic seizures involve abnormal electrical discharges in the brain. Functional seizures do not.

The modern diagnosis is based on positive clinical features of the attacks, ideally supported by a specialist who understands both epilepsy and FND.

What Are Dissociative Seizures?

Dissociative seizures are one type of functional neurological disorder.

You may also hear them called:

• Functional seizures
• Functional dissociative seizures
• Non epileptic attacks
• Non epileptic seizures
• NEAD
• Psychogenic non epileptic seizures
• PNES

The older term “pseudoseizure” should be avoided because it can wrongly suggest that the event is false or deliberate.

The attacks are genuine neurological symptoms.

11 Crucial Facts About Dissociative Seizures

1. Dissociative Seizures Are Real

This is the most important starting point.

The person is not pretending.

The movements, loss of awareness, shaking, collapse, or inability to respond are involuntary.

A normal brain scan does not mean nothing is wrong.

Functional neurological disorders involve changes in how brain networks function rather than a structural lesion that can always be seen on MRI.

2. They Are Not the Same as Epilepsy

Epileptic seizures are caused by sudden abnormal electrical activity in the brain.

Functional seizures happen through a different brain mechanism.

This distinction matters because the treatments are different.

Antiseizure medicines treat epilepsy. They rarely treat functional seizures.

3. Symptoms Can Vary Widely

There is no single appearance.

An episode may include:

• Whole-body shaking
• Side-to-side movements
• Jerking
• Stiffness
• Falling
• Closed eyes
• Staring
• Loss of responsiveness
• Long periods of immobility
• Changes in breathing
• Difficulty speaking afterward
• Memory gaps

Some attacks last longer than many epileptic seizures.

Others are short.

4. Trauma Is Not Required

Older explanations sometimes suggested that every person with dissociative seizures must have experienced trauma or severe psychological stress.

That is too simple.

Trauma, anxiety, depression, panic, chronic stress, or other life experiences can matter for some people.

Other people do not identify any clear psychological trigger.

The absence of trauma does not make the diagnosis less valid.

5. A Person Can Have Epilepsy and Functional Seizures

This is another reason self-diagnosis can be dangerous.

A person may experience both disorders.

One type of event may be epileptic while another is functional.

This means that a previous epilepsy diagnosis does not automatically explain every later attack.

6. Diagnosis Should Be Based on Positive Evidence

Functional seizures should not be diagnosed only because tests for epilepsy are normal.

Doctors look for positive features that fit functional seizures.

These can include:

• The pattern of movement
• Duration
• Responsiveness
• Eye and facial features
• Warnings before the attack
• Recovery pattern
• Variability between attacks

A specialist familiar with seizure disorders is best placed to interpret these signs.

7. Video EEG Can Be Very Valuable

Video EEG records both the person's behaviour and the electrical activity of the brain.

If a typical attack occurs during the recording, doctors can compare what the body is doing with what the brain's electrical activity shows.

This can help separate an epileptic seizure from a functional seizure.

A normal routine EEG by itself does not prove that a person has functional seizures.

NICE specifically warns that EEG should not be used simply to exclude epilepsy.

8. Antiseizure Medicine Usually Does Not Treat Functional Seizures

The American Academy of Neurology's 2025 guideline recommends against antiseizure medicines and benzodiazepines for functional seizures when there is no coexisting epilepsy or another medical reason to use them.

If a person has been taking epilepsy medicine after a previous misdiagnosis, it should not be stopped suddenly without medical supervision.

A clinician can plan a safe reduction when appropriate.

9. Psychological Treatment Can Help

Psychological treatment is not offered because the seizures are imaginary.

It is used because brain function, attention, stress systems, emotion, bodily responses, and learned patterns can all influence functional neurological symptoms.

Possible approaches include:

• Cognitive behavioural therapy
• Other structured psychological therapies
• Trauma-focused treatment when trauma is relevant
• Therapy for anxiety or depression
• Education about FND

The 2025 AAN guideline found that psychological interventions are possibly effective in reducing functional seizure frequency and may improve anxiety and quality of life.

10. Learning Self-Management Skills Matters

Some people notice warnings before an attack.

These may include:

• Feeling detached
• Dizziness
• Racing heart
• Chest tightness
• Visual changes
• Feeling overwhelmed
• Changes in breathing
• Numbness

Learning to recognize early warning signs can create an opportunity to use grounding or regulation strategies before the attack becomes stronger.

11. Recovery Is Possible

Some people stop having functional seizures completely.

Others have fewer attacks or learn to manage them more effectively.

Recovery is not always linear.

Symptoms can improve, return during stressful periods, and improve again.

Useful goals can include:

• Fewer seizures
• Shorter episodes
• Better warning awareness
• Returning to work or education
• Improved confidence
• Better sleep
• Reduced anxiety
• Improved quality of life

Dissociative Seizures Versus Epileptic Seizures

Individual seizure appearances overlap too much for a person to diagnose the difference from a checklist alone.

What Causes Dissociative Seizures?

There is no single cause that applies to everyone.

Functional seizures can emerge from a combination of factors involving brain networks, attention, emotion, bodily responses, previous illness, stress systems, and learned patterns.

Possible contributing factors may include:

• Previous stressful experiences
• Trauma in some people
• Anxiety
• Depression
• Panic symptoms
• Chronic pain
• Sleep problems
• Physical illness
• Other FND symptoms
• Long periods of stress

Sometimes no obvious trigger is identified.

That does not mean the symptoms are less real.

What Is Dissociation?

Dissociation describes a temporary disruption in the normal connection between awareness, memory, perception, emotion, or the sense of the body.

A person may describe:

• Feeling detached from themselves
• Feeling that the world is unreal
• Losing track of time
• Memory gaps
• Feeling disconnected just before an attack

Not every person with functional seizures experiences obvious dissociation.

What Does a Dissociative Seizure Feel Like?

Different people describe very different experiences.

Before an attack, someone might notice:

• Dizziness
• Heat
• Shaking
• Heart pounding
• Numbness
• Tunnel vision
• A sense of unreality
• Fear
• Difficulty speaking

During the episode, awareness may be reduced or absent.

Some people remember everything while being unable to respond.

How Long Can Dissociative Seizures Last?

There is no fixed duration.

Some are brief, while others last several minutes or longer.

Epilepsy Action notes that functional seizures can sometimes continue for more than five minutes, which is one reason they can be confused with epileptic status.

A known functional seizure care plan can help emergency teams avoid unnecessary treatment.

Can Dissociative Seizures Cause Brain Damage?

Functional seizures themselves are not caused by epileptic electrical activity and are not believed to damage the brain in the way prolonged uncontrolled epileptic seizures can.

However, injuries can happen during falls or uncontrolled movements.

Safety still matters.

Can Dissociative Seizures Happen During Sleep?

Some people report events around sleep or apparent sleep.

True epileptic seizures can also occur during sleep.

Events that occur at night or during apparent sleep therefore need careful specialist assessment rather than being labelled from symptoms alone.

How Are Dissociative Seizures Diagnosed?

The diagnosis usually starts with a detailed history.

A clinician may ask:

• What happens before the attack?
• What does the person feel?
• How do movements begin?
• Are the eyes open or closed?
• How long does the event last?
• Can the person respond?
• How quickly do they recover?
• Are all attacks identical?
• Is epilepsy already diagnosed?

A witness description can be extremely valuable.

Why Smartphone Video Can Help

If it is safe, a family member or friend may record an episode.

Epilepsy specialists can often learn a great deal from seeing the event.

Safety always comes first.

Do not keep filming instead of protecting the person from injury or getting emergency help when needed.

What Is Video EEG?

Video EEG combines:

• A video recording
• Continuous EEG brain wave recording

The aim is to capture one of the person's typical attacks.

If the clinical event occurs without the epileptic electrical pattern expected for that event, and the appearance has positive functional features, the result can strongly support a functional seizure diagnosis.

Can a Normal EEG Rule Out Epilepsy?

No.

This is important.

People with epilepsy can have a normal EEG between seizures.

NICE specifically states that EEG should not be used simply to exclude epilepsy.

Diagnosis depends on the whole clinical picture.

Are Brain Scans Used?

MRI or CT may be used when doctors need to look for another neurological condition.

Brain imaging does not diagnose functional seizures.

A normal MRI does not by itself prove that the attacks are functional.

Why Is an ECG Sometimes Done?

Some heart rhythm problems can cause fainting, collapse, or jerking that resembles a seizure.

NICE recommends a 12 lead ECG after a first suspected seizure to help identify cardiac conditions that can mimic epilepsy.

Blood glucose and other metabolic problems may also be checked depending on the situation.

Can Low Blood Sugar Look Like a Seizure?

Yes.

Severe hypoglycaemia can cause confusion, loss of consciousness, abnormal behaviour, or seizures.

This is one reason the first episode should not be assumed to be functional.

Read our What Causes Low Blood Sugar Without Diabetes? guide for more context.

What Is the First Aid for Dissociative Seizures?

Protect the Person From Injury

Move sharp, hot, or hard objects away.

Cushion the person's head when possible.

Do Not Restrain Them

Holding someone down can cause injury.

Do Not Put Anything in Their Mouth

A person cannot swallow their tongue.

Never place fingers, spoons, food, drinks, or other objects in the mouth during an attack.

Stay Calm

Speak quietly and reassuringly.

A calm environment may help recovery.

Time the Attack

Knowing the duration helps clinicians understand what happened.

Use the Recovery Position

Once the strong movements stop, place the person on their side if appropriate and monitor breathing.

Stay Until Recovery

Do not leave someone alone while they are confused or unsteady.

When Should You Call an Ambulance?

Call emergency services if:

• It is the person's first suspected seizure
• You do not know what type of seizure it is
• They are not breathing normally
• They are seriously injured
• They have repeated attacks without normal recovery
• The situation differs from their usual diagnosed episodes
• They remain unusually unresponsive afterward

Epilepsy Action also advises emergency help when an event continues beyond five minutes or the person remains unresponsive for more than ten minutes afterward, unless an individualized medical plan says otherwise.

How Are Dissociative Seizures Treated?

There is no single treatment that works for everyone.

A good plan often begins with a clear explanation of the diagnosis.

Treatment may include:

• Education about FND
• Psychological therapy
• Learning warning signs
• Grounding techniques
• Breathing regulation
• Managing sleep
• Treating anxiety or depression
• Treating pain
• Occupational therapy
• Physiotherapy when other FND movement symptoms exist

What Is Cognitive Behavioural Therapy?

Cognitive behavioural therapy, or CBT, is one psychological approach used for functional seizures.

It may help a person:

• Recognize attack patterns
• Understand warning symptoms
• Change responses to bodily sensations
• Reduce avoidance
• Manage stress
• Build confidence

Therapy should be adapted to the person's own symptoms and circumstances.

Is Trauma Therapy Always Needed?

No.

Trauma-focused therapy may be appropriate when trauma is clearly relevant, and the person wants to address it.

Not everyone with functional seizures has trauma.

Treatment should not force a trauma explanation onto someone whose history does not support it.

Do Antidepressants Stop Dissociative Seizures?

There is no medication specifically approved to stop functional seizures.

Antidepressants may still be useful when a person also has:

• Depression
• Anxiety
• Panic disorder
• Another condition for which the medicine is appropriate

Treating those conditions can improve overall wellbeing, but the medicine is not an antiseizure treatment for FND itself.

Should Epilepsy Medicine Be Stopped?

Only under specialist guidance.

The 2025 AAN guideline advises that antiseizure medicine should not be used for functional seizures when epilepsy is not also present.

However, stopping some seizure medicines suddenly can be unsafe.

A neurologist should decide whether and how they should be reduced.

Grounding Strategies That May Help

If you notice a warning before an attack, some people find it useful to focus attention outward.

Examples include:

• Name five things you can see
• Notice the feeling of your feet on the floor
• Describe objects around you
• Slow your breathing
• Relax your shoulders
• Hold a cool object
• Speak with someone nearby

These strategies do not work for everyone.

They are tools rather than cures.

You can also explore our Deep Breathing Meditation Guide for general relaxation techniques.

Keep a Seizure Diary

A diary can help identify patterns.

Record:

• Date
• Time
• Where you were
• What happened beforehand
• Warning symptoms
• Estimated duration
• What the event looked like
• Recovery time
• Sleep the previous night
• Stress level
• Pain
• Medication changes

The goal is not to blame yourself.

It is to gather useful information.

Can Stress Trigger Dissociative Seizures?

Yes, stress can be a trigger for some people.

However, not every attack follows obvious stress.

An episode can also happen during a calm moment.

Stress is one factor rather than a requirement for diagnosis.

Can Anxiety Cause Dissociative Seizures?

Anxiety and panic can occur alongside functional seizures and may contribute to attacks in some people.

Other people have no obvious anxiety immediately before an episode.

A mental health diagnosis should not be assumed simply because functional seizures are present.

Can You Drive With Dissociative Seizures?

Driving rules depend on where you live.

In the UK, functional seizures that affect consciousness or control can affect driving eligibility and must be discussed with the DVLA and your medical team.

Do not drive if there is a meaningful risk that an attack could make you lose control of the vehicle.

People outside the UK should check local licensing rules.

Can You Work With Dissociative Seizures?

Many people can work, but workplace adjustments may be useful.

Examples include:

• A written seizure plan
• A safe place to recover
• Flexible breaks
• Reducing unnecessary triggers
• Avoiding unsafe heights
• Reviewing driving tasks
• Informing selected colleagues about first aid

The aim should be safe participation rather than automatic exclusion.

Can Dissociative Seizures Happen With Other FND Symptoms?

Yes.

A person may also experience:

• Functional weakness
• Tremor
• Jerks
• Walking difficulty
• Functional sensory symptoms
• Speech problems
• Dizziness
• Functional cognitive symptoms

FND treatment may therefore involve several health professionals.

What Does Recovery Look Like?

Recovery may mean more than stopping seizures completely.

Progress can include:

• Longer gaps between attacks
• Shorter attacks
• Better recognition of warnings
• Fewer injuries
• Returning to work
• Returning to education
• Reduced fear
• Better sleep
• Improved relationships
• Greater independence

Relapses can happen.

A relapse does not erase previous progress.

A Simple Functional Seizure Management Plan

Common Myths About Dissociative Seizures

Myth 1: The Person Is Faking the Seizure

False.

Functional seizures are involuntary and real.

Myth 2: A Normal EEG Proves the Seizure Is Functional

False.

People with epilepsy can have a normal EEG between attacks.

Myth 3: Everyone With Functional Seizures Has Trauma

False.

Trauma is relevant for some people but is not required for the diagnosis.

Myth 4: Epilepsy Medicine Treats Functional Seizures

Usually false.

Antiseizure medication does not treat functional seizures unless the person also has epilepsy or another medical reason for the medicine.

Myth 5: There Is No Treatment

False.

Education, psychological treatment, self-management skills, treatment of related conditions, and rehabilitation can help.

Conclusion

Dissociative seizures are real, involuntary neurological events that can closely resemble epilepsy.

The difference is not whether the symptoms are real. The difference is the mechanism causing them.

Accurate diagnosis matters because functional seizures and epileptic seizures need different treatments. Video EEG, specialist assessment, witness descriptions, and safe smartphone videos can all help when the diagnosis is unclear.

If you have been diagnosed with functional seizures, ask your clinician to explain why the diagnosis fits, what treatment is recommended, and what your personal first aid and emergency plan should include.

Recovery is possible, and improvement may involve fewer attacks, better control, less fear, and a return to everyday activities.

References and Sources

1. American Academy of Neurology. Management of Functional Seizures Practice Guideline. December 2025.
   https://www.aan.com/PressRoom/Home/PressRelease/5302
2. Epilepsy Action. Functional Dissociative Seizures.
   https://www.epilepsy.org.uk/info/seizures/dissociative-seizures-non-epileptic-attack-disorder-nead
3. NICE. Epilepsies in Children, Young People and Adults: Diagnosis and Assessment.
   https://www.nice.org.uk/guidance/ng217/chapter/diagnosis-and-assessment-of-epilepsy
4. Neurosymptoms.org. Functional Dissociative Seizures.
   https://neurosymptoms.org/en/symptoms/fnd-symptoms/functional-dissociative-seizures/
5. Neurosymptoms.org. Treatment of Functional Neurological Disorder.
   https://neurosymptoms.org/en/treatment/

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Frequently Asked Questions

What are dissociative seizures?

Dissociative seizures, also called functional seizures, are real involuntary attacks that can involve shaking, collapse, staring, or loss of responsiveness. They are not caused by the abnormal electrical activity seen in epilepsy.

Are dissociative seizures the same as epilepsy?

No. Epileptic seizures involve abnormal electrical discharges in the brain, while dissociative seizures are a form of functional neurological disorder. A person can have both conditions.

Are dissociative seizures fake?

No. The symptoms are real and involuntary. The person is not pretending or consciously producing the attack.

What causes dissociative seizures?

There is no single cause. Factors may include changes in brain function, stress, trauma in some people, anxiety, depression, pain, sleep problems, illness, or other FND symptoms. Some people have no obvious psychological trigger.

How are dissociative seizures diagnosed?

Diagnosis is based on positive clinical features, specialist assessment, witness descriptions, videos when available, and sometimes video EEG that captures a typical attack.

Can a normal EEG prove that a seizure is dissociative?

No. People with epilepsy can have a normal EEG between seizures. Video EEG is more useful when it captures the person's typical event and is interpreted with the clinical features.

Do epilepsy medicines treat dissociative seizures?

Usually not. Current guidance recommends against antiseizure medicines for functional seizures unless the person also has epilepsy or another medical reason for the medicine.

What treatment helps dissociative seizures?

Treatment may include education about FND, psychological therapy, learning warning signs, grounding strategies, management of anxiety, depression, pain, or sleep problems, and rehabilitation when other functional symptoms are present.

What should I do during a dissociative seizure?

Protect the person from injury, cushion the head, do not restrain them, put nothing in the mouth, time the event, stay calm, and remain with them until they recover.

When should I call an ambulance?

Call emergency services for a first suspected seizure, an event when the diagnosis is unknown, abnormal breathing, serious injury, repeated attacks without recovery, prolonged unresponsiveness, or an episode that is very different from the person's usual diagnosed events.

Can people recover from dissociative seizures?

Yes. Some people stop having attacks completely, while others have fewer or shorter episodes and regain more control. Recovery may involve therapy, education, self-management strategies, and treatment of related health problems.

Adel Galal

Health & wellness writer with 30+ years of experience in nutrition, fitness, and healthy aging. Founder of NextFitLife.com — evidence-based health guidance.