Addressing evaluation challenges and incorporating psychotherapeutic interventions in the diagnosis of functional seizures: A case report

Functional seizures (FSs) are a subset of functional neurological disorders frequently misdiagnosed due to their clinical overlap with neurological conditions. Unlike epileptic seizures, they occur without abnormal neuronal discharges and manifest through diverse motor, sensory, and cognitive symptoms. This case report presents the diagnostic trajectory of a patient initially misdiagnosed with stroke-related motor symptoms and later epilepsy, subsequently reevaluated at Ramos Mejía Hospital in Buenos Aires. A comprehensive multidisciplinary assessment involving a differential diagnosis process was conducted to confirm the diagnosis of FSs by ruling out epilepsy, autoimmune encephalitis, and concomitant psychosis. The implementation of targeted psychoeducation, symptom monitoring, and interventions based on the integrative cognitive model resulted in significant clinical improvement, including reduced seizure frequency and enhanced functional mobility. Furthermore, psychotherapeutic strategies facilitated patient acceptance of the diagnosis and adherence to treatment. This case underscores the diagnostic challenges associated with FSs and highlights the importance of a multidisciplinary, individualized approach to optimize symptom management and patient outcomes.