Expert: Functional Seizures ‘Exist at the Boundary Between Psychiatry and Neurology’

Contemporary Clinic® interviewed Lea Davis, PhD, an associate professor of medicine in the Department of Medicine at Vanderbilt University Medical Center and an investigator in the Vanderbilt Genetics Institute, on a recent study she co-authored that was published in JAMA Network Open on the epidemiology of functional seizures among adults treated at a university hospital.

Alana Hippensteele: Why are confirmed associations between functional seizures and psychiatric conditions, such as [post-traumatic stress disorder (PTSD)], anxiety, depression, and sexual assault trauma, potentially important in terms of understanding and treating functional seizures?

Lea Davis: So functional seizures really kind of exist at the boundary between psychiatry and neurology, which is actually one of the reasons why they've been historically so poorly understood and so understudied.

We have this kind of historical separation between psychiatry and kind of the rest of medicine, and functional seizures are one of those boundary conditions where you really need a treatment team and support from multiple domains.

So, I think reaffirming that this is a truly an association that we see in a much larger population is important from that perspective, but then also the relationship that functional seizures seem to have kind of specifically with trauma I think is going to be important in our understanding of how and why these seizure conditions develop.

So, I have kind of come to think of functional seizures as potentially being a neurological consequence of trauma. Now, that doesn't mean that trauma is the only thing that can cause functional seizures, I think it's a heterogeneous kind of condition, so there are lots of potential causes. But certainly, we see that there is a stark over-representation of trauma in functional seizure cases.