Functional seizures: An evaluation of the attitudes of general practitioners local to a tertiary neuroscience service in London

Abstract

Summary Objective Functional seizures are a common functional neurologic disorder. Given their chronic nature, and the biopsychosocial factors involved in their etiology, general practitioners (GPs) play a crucial role in the care of these patients. However, little is known about the attitudes of GPs toward, and knowledge of, functional seizures. Methods The Atkinson Morley Regional Neuroscience Centre in London provides a comprehensive service to patients with functional seizures. As part of a service evaluation we conducted an online survey among local GPs over a 1‐month period assessing their attitudes toward, and knowledge of, functional seizures. Results One hundred twenty of 974 surveyed GPs replied to the survey (12.3%). Approximately 75% of GPs readily use the term “pseudoseizures,” and over 50% were not sure or did not think that functional seizures were involuntary. Nearly 30% believed, or were unsure as to whether, functional seizures occur only when patients are stressed. Despite approximately 50% of GPs expressing interest in getting involved in the management of these patients, a similar proportion do not feel confident in dealing with queries from patients with functional seizures. Although most GPs felt that neurology and psychiatry should be the primary caregivers in the diagnosis and management, respectively, of functional seizures, 50% were also of the opinion that neurology should be involved in the management of these patients. Significance This survey highlights the attitudes of, and descriptive terms used by, GPs toward patients with functional seizures. Our findings suggest a need for better and clearer provision of information to GPs about this condition.

#3100 A service evaluation of the experiences of patients with functional neurological disorders within the NHS

“…For example, consultants have previously reported that they found people with FND more difficult to treat and support (41). Additionally, multiple studies have identified negative perceptions of FND in various healthcare professionals, including neurologists, psychiatrists, GPs, and nurses (18,(42)(43)(44). Lehn et al (38) survey of healthcare practitioners linked these negative perceptions to a fundamental lack of knowledge or misunderstanding of what FND is.…”

“…Further, professionals in primary care settings, such as GPs, are often the facilitators via which specialist management can be accessed, and thus the attitudes and ethical presumptions of these primary care professionals can provide additional barriers in accessing appropriate care. Negative perceptions of patients with FND amongst a variety of healthcare professionals (18)(19)(20) arising from a lack of knowledge about the condition and suspicion of feigning may also impact the extent to which patientcentred care is provided and lead to greater stigmatisation of these patients (21). These barriers may therefore impact on the experience of people with FND as they navigate health systems in order to obtain the help they need.…”

Terminology for psychogenic nonepileptic seizures: Making the case for “functional seizures”

“…When presenting the diagnosis of this condition to a patient, a specific and clear label for the seizures should be provided at the beginning of the encounter along with an appropriate description of the condition to the patients and their families 18 . Some authors have already adopted this term (i.e., functional seizures) to describe this condition [28][29][30] .…”

Differentiating Psychosomatic, Somatopsychic, Multisystem Illnesses and Medical Uncertainty

“…Physicians have mixed opinions regarding the etiology of what is called psychogenic seizures [90]. Unfortunately, partial seizure activity that is localized deep within the brain cannot always be measured with the current diagnostic technology that measures seizure activity on the surface of the brain [91].…”