A study conducted by Michigan Medicine suggests that the mortality rate in patients with functional non-epileptic seizures is higher than expected, comparable to epilepsy and serious mental illnesses.
A research team reviewed data from 700 patients diagnosed with functional seizures, also called psychogenic or non-epileptic seizures, between 2014 and mid-2023, and observed them for an average of 15 months.
It is the largest study of its kind in the United States and aligns with international studies in Australia, Denmark, Sweden, and the United Kingdom, all of which have nationalized healthcare systems.
Of the 700 patients with functional seizures, 11 died, a mortality rate almost 2.5 times higher than the number of people who would die in the same period among comparable individuals without functional seizures.
The results are published in Neurology: Clinical Practice.
„Functional seizures have long been stigmatized by healthcare professionals, and our results underscore the seriousness of the diagnosis,“ said lead author Nicholas J. Beimer, MD, clinical associate professor in the Departments of Neurology and Psychiatry at UM Medical School.
„The results show that the stigma that this illness is not relevant or serious to healthcare professionals can clearly be dismissed, and that the access of this population to healthcare must be improved.“
The researchers found that the mortality rate was comparable to that of patients with epilepsy and serious mental illnesses, including schizophrenia and depression.
Almost all deaths of patients in the registry had a known cause related to comorbidities of functional seizures, such as stroke, neurodegenerative diseases, and cancer.
„All of the patients who died in our study had significant medical comorbidities, and this should encourage us to treat patients with functional seizures from a holistic perspective, considering both their mental health and physical health simultaneously, rather than separately,“ said Elissa H. Patterson, Ph.D., co-author, clinical assistant professor of psychiatry at the UM Medical School.
G. Scott Winder, MD, M.Sc., clinical associate professor of psychiatry at the University of Michigan Medical School.“ Our healthcare system in the United States systematically separates mental and physical health into different silos, and it should not be this way,“ said Co-Author.
„The first death of the patients studied occurred just over five months after their referral for treatment. Researchers suggest that access to holistic, multidisciplinary treatment for functional neurological disorders needs to be improved in order to initiate treatment for patients earlier,“ the researchers noted.
„Due to the limited number of health centers with multidisciplinary clinics dedicated to the assessment and treatment of functional seizures, this research should motivate current clinics to increase their capacities and achieve these time-based goals, as well as encourage other centers to introduce new treatments for this serious condition,“ said Najda Robinson-Mayer, LMSW, a clinical social worker at UM Health who leads the teletherapy group for psychogenic non-epileptic seizures/functional seizures in the Department of Neurology.
„We recently developed a virtual group therapy program for functional seizures so that patients can start treatment within weeks of diagnosis rather than months,“ she added.
Functional seizures are often misdiagnosed as epilepsy; many patients are treated for epilepsy for years before receiving the correct diagnosis.
„An early diagnosis and treatment not only has the potential to improve outcomes for people with functional seizures, but also significantly reduces the likelihood of being treated with expensive antiepileptics that do not work for their condition,“ said principal author Wesley T Kerr, MD, assistant professor of neurology at the University of Pittsburgh Medical Center, who worked at UM Health during the research. „The goal is to get these patients the right treatment as soon as possible.“
Michigan Medicine – University of Michigan
Kerr, WT, et al. (2024). Increased mortality rate in patients with functional seizures after diagnosis and referral. Neurology Clinical Practice. doi.org/10.1212/cpj.0000000000200227.