Key Practice Takeaways From the New AAN Functional Seizure Guidelines

Episode 159,   Jan 23, 11:00 AM

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Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.

In this Mind Moments episode, Benjamin Tolchin, MD, MS, FAAN, joins the podcast to provide clinical perspective on the recently published American Academy of Neurology (AAN) guidelines on functional seizures, drawing on his role as a contributing author to the recommendations. Tolchin, Director of the Center for Clinical Ethics at Yale New Haven Health and Associate Professor of Neurology at Yale School of Medicine, discusses what prompted the development of the first AAN guideline in this space and how the evidence base evolved to support formal recommendations. The conversation explores key considerations around diagnosing functional seizures, including history, semiology, EEG use, and the growing role of video documentation. Tolchin also addresses how clinicians should approach psychiatric comorbidities and co-occurring epilepsy, the evidence supporting psychological interventions, why pharmacologic therapies are not recommended for functional seizures themselves, and where major gaps remain in research to advance care in the years ahead.

Looking for more Epilepsy discussion? Check out the NeurologyLive® Epilepsy clinical focus page.

Episode Breakdown:

  • 1:10 – Why growing evidence prompted the first AAN guideline on functional seizures
  • 3:20 – Diagnostic priorities including history, semiology, EEG, and video documentation
  • 6:15 – Assessing psychiatric comorbidities and co-occurring epilepsy in functional seizures
  • 9:15 – Neurology News Minute
  • 11:30 – Evidence supporting psychotherapy for functional seizures
  • 14:50 – Pharmacological evidence and use of antiseizure medications for functional seizures
  • 18:35 – Barriers to advancing clinical trials in functional seizures
  • 22:05 – Research priorities to refine treatment and long-term outcomes


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