Treatment Provided in Children and Adolescents with Functional Seizures-A Danish Nationwide Cohort

Background: Functional seizures (FS) are episodes of paroxysmal involuntary movements and altered consciousness without the typical changes in the electroencephalography as with epilepsy. A multidisciplinary approach is the golden standard in the treatment of FS. This study examined the cross-sectoral collaboration and treatment modalities provided to children and adolescents after a diagnosis of FS. Method: A Danish nationwide cohort, consisting of 334 children and adolescents, aged 5-17 years, with a validated diagnosis of FS during the period 2004-2014 was studied. Medical record data were collected from diagnosing hospital departments. Management and treatment modalities from the time of diagnosis up to three months after diagnosis were explored. Results: The most used treatment modalities were psychoeducation (n = 289, 86.5%) and follow-up in outpatient care (n = 192, 70.6%). A cross-sectoral collaboration was initiated for a third of cases (n = 98, 29.3%). The most commonly provided treatment combination consisted of psychoeducation, follow-up in outpatient care and psychotherapy; however, only a few patients received this specific combination (n = 14, 4.2%). Conclusions: The treatment applied was individualized and consisted of varying use of treatment modalities. Initiatives to curate clinical guidelines and implement a multidisciplinary treatment approach should be further explored to improve treatment for this young group of patients.

Automated summary

This study examined the treatment and collaboration among 334 Danish children and adolescents diagnosed with functional seizures. The most commonly used treatment modalities were psychoeducation and outpatient follow-up. Only a few patients received the recommended combination of psychoeducation, outpatient follow-up, and psychotherapy. Implementing a multidisciplinary treatment approach should be explored to improve the treatment for this group.