Heart Rate and Autonomic Biomarkers Distinguish Convulsive Epileptic vs. Functional or Dissociative Seizures

Epileptic seizures (ES) are due to transient electrical disturbances in neurons that lead to synchronous discharges. Functional or dissociative seizures (FDS) result in motor, sensory, and behavioral manifestations that are similar to ES, but there are no abnormalities detected on the electroencephalogram (EEG) [1]. FDS are associated with a history of psychological distress, particularly in individuals with a history of trauma/abuse [1–4]. FDS occur in 20-40% of patients admitted to the epilepsy monitoring unit, 40% of patients in general neurology clinics, and ranks in the top 3 neuropsychiatric diseases (3:100,000 patients/year) [1,2,5-8].

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