Dissociative seizures in the emergency department: how to solve the problem of diagnostic confusion leading to iatrogenic harm?

Dissociative seizures are frequently misdiagnosed and treated as epileptic seizures in emergency settings, but simple educational interventions may help Over the last 20 years, there has been a renaissance in the study of functional neurological disorders (FNDs). Alongside an improved understanding of their involuntary nature,1 and mechanistic and aetiological complexities,2 there is an increasing recognition of the iatrogenic harm and socioeconomic costs associated with these disorders. Dissociative seizures are the most common form of FND. They look like epileptic seizures but are not caused by epileptiform discharges. Individuals with dissociative seizures have elevated morbidity3 and mortality rates,4 and significant associated healthcare costs.5 Individuals will typically present to an emergency department, often more than once. This should therefore provide an ideal opportunity to make a positive diagnosis, triage individuals into appropriate treatment pathways and ultimately reduce iatrogenic harm and...
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Editorial commentaries Source Type: research