Functional Seizures Linked to Higher Risk for Mortality
TOPLINE:
Patients with functional seizures had an approximately twofold higher risk for mortality than people without seizure disorders even after controlling for mental and physical health comorbidities; however, this risk remained roughly half that observed in those with epileptic seizures.
METHODOLOGY:
Researchers compared mortality among patients with functional seizures, those with epileptic seizures, and those without seizure disorders by using an international electronic health record database to assess whether the increased risk persisted after accounting for mental and physical health comorbidities.
The study included 32,854 patients with functional seizures (without epileptic seizures), 1,916,787 patients with epileptic seizures (without functional seizures), and 21,053,677 participants without seizure disorders.
Comorbid mental and physical health conditions were assessed using standard diagnostic codes if diagnosed within 3 years before or at the index diagnosis; outcomes were measured at any time after the index diagnosis.
TAKEAWAY:
Patients with functional seizures showed significantly higher proportions of all mental and physical health disorders than those without seizure disorders and higher proportions of most categories of mental and physical health disorders than those with epileptic seizures (P < .001 for all).
After controlling for demographics and comorbidities, patients with functional seizures had approximately double the risk for mortality compared to people without seizure disorders but approximately half the risk compared to those with epileptic seizures (hazard ratio for epileptic vs functional seizures, 2.07; 95% CI, 1.922-2.235).
Among patients with functional seizures, the risk for mortality was highest in the first year following diagnosis and in those aged 40-49 years.
IN PRACTICE:
"Our results nevertheless present an alarming risk of premature death in people with FS [functional seizures], which although still only half of that in people with ES [epileptic seizures], is still more than twice that in NS [people without seizure disorders] and is not attributable to the many comorbidities found in FS," the authors wrote.
SOURCE:
This study was led by Richard A. Kanaan, University of Melbourne, Austin Hospital, Heidelberg, Melbourne, Australia. It was published online on March 31, 2026, in Epilepsia.
LIMITATIONS:
Mortality data in the international healthcare database were incomplete, and data were limited to all-cause mortality, with no information on specific causes of death. The shorter follow-up duration for patients with functional seizures may have influenced the risk comparison and timing of death.
DISCLOSURES:
The authors did not explicitly mention about funding. Some of the authors declared receiving grant funding, royalties, honoraria, and/or consulting fees from various organisations and institutions.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.