For clients · 5 min read

Functional seizures (PNES) explained

Real seizures. Not epilepsy. Not faking. A brain-network disorder that responds to therapy.

Metaphor: A circuit breaker that trips under load — the wiring is fine, but the breaker keeps flipping.

Interactive

The warning window

Most functional seizures are preceded by a warning wave — seconds to minutes of dread, dizziness or tingling. Catching it early can abort the event.

window

Without an interrupt, the wave tips over into an event. The window is the intervention.

Try one now · 60 seconds
Use the warning window

When you notice the warning wave, do grounding immediately: cold water, push feet into the floor, name 5 things you see. Catching it early can abort the event.

Functional seizures are real seizures

If you've been told you have functional seizures, dissociative seizures, or PNES (psychogenic non-epileptic seizures), it means the events you're having are genuine, involuntary, and not caused by abnormal electrical activity in the brain — which is what epilepsy is. The older term 'pseudoseizures' is no longer used; it was stigmatizing and wrong. These are real episodes, and they are treatable.

What's happening in the brain

The brain hardware is working. The software — how the brain routes attention, emotion, and motor signals — has gotten dysregulated. Sometimes a circuit-breaker trips: when input becomes overwhelming (emotional, sensory, or remembered), the system shuts down or shakes in a way that looks like a seizure. For many people, there's a trauma history; for many others, there isn't. Both are valid paths to the same diagnosis.

The warning window

Most functional seizures are preceded by a feeling — a wave of dread, dizziness, a tingling, a 'here it comes' — anywhere from a few seconds to a couple of minutes before the event. That window is the most important piece of treatment. Learning to recognize it and use grounding, breath, and movement in that window can abort the seizure.

Therapy that works

The best-studied treatment is a 12-session CBT-informed protocol (sometimes called CBT-ip, developed by Dr. W. Curt LaFrance). Sessions cover seizure logs, trigger mapping, warning-sign skills, relaxation, communication, and — when relevant — trauma processing with proper pacing. Studies show seizures reduce by about half on average, alongside better mood and quality of life.

You might be here if…

Try this

Use the warning window
When you notice the warning wave, do grounding immediately: cold water, push feet into the floor, name 5 things you see. Catching it early can abort the event.
Slow exhale
Inhale 4, exhale 8. Longer exhale calms the autonomic system before it tips over.
Track patterns
Keep a brief seizure log: time, place, what was happening, what you felt beforehand. Patterns become visible quickly.
Communicate the diagnosis
Share neurosymptoms.org or fndhope.org with people in your life. Understanding from others lowers the shame that fuels the cycle.

Common questions

Is this 'faking' or 'in my head'?+

No. Functional seizures are involuntary and real. The events come from nervous-system dysregulation, not from choosing or imagining them.

Will epilepsy medication help?+

No — and it's important to know that. Anti-seizure meds don't help functional seizures and can have side effects. The treatment is therapy.

Can they go away?+

Often, yes. The CBT-informed protocol shows about a 50% reduction on average, and many people become seizure-free over time.

When to reach out

If you've been diagnosed with PNES or functional seizures, ask about CBT-ip (LaFrance protocol) with a clinician trained in this area.

The takeaway

Functional seizures are real, treatable, and not your fault. The same nervous system that learned to flip the breaker can learn another way through.

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