Objective: This analysis examined the association between adverse childhood experiences (ACE) and functional seizures among FND patients.

Background: Functional seizures are seizures of undetermined organic or structural cause that fall under the wide spectrum of Functional Neurological Disorders (FND). The etiology of functional seizures is unknown and remains largely misunderstood. Childhood trauma has been implicated as a possible cause for developing Functional Seizures [1]. However, the specific contribution of childhood trauma to functional seizures remains poorly understood.

Method: Cross sectional design with a sample of 251 participants who self-reported FND included in the international FND Patient Registry.  Cumulative adverse childhood experiences (ACE) scores were categorized and we also examined specific ACEs as measures of childhood trauma. T-test was done to identify the difference between cumulative ACE scores in those with seizures and those without. Chi square was conducted for difference of proportion to identify the association between specific ACES and functional seizures. Logistic regression was conducted to estimate the odds of functional seizures (OR) with 95% CI adjusting for gender, age, employment status, marital status, volunteering, and insurance.

Results: Functional seizures were present in 53% of the study sample. The prevalence of each ACE ranged from 7.17% to 44.6%. After adjusting for confounders, individuals’ cumulative ACE score was significantly associated with functional seizures (AOR = 1.12; 95% CI: 1.00 – 1.26) (Table 1).  Regarding specific ACE, individuals who witnessed domestic violence against their mothers were more likely to have functional seizures (AOR = 4.36; 95% CI 1.39 – 13.76) (Table 2).

Conclusion: Although a minority of individuals with FND in our patient registry had functional seizures, those that did were found to have an increased odds of ACEs in this study.  Further evaluation is needed to confirm that this relationship represents a specific risk factor for Functional Seizures. Future studies are also needed to compare populations of patients with other non-FND neurological disorders to serve as a control group.

References: [1] Ludwig L, Pasman JA, Nicholson T, Aybek S, David AS, Tuck S, Kanaan RA, Roelofs K, Carson A, Stone J. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies. Lancet Psychiatry. 2018 Apr;5(4):307-320. doi: 10.1016/S2215-0366(18)30051-8. Epub 2018 Mar 8. PMID: 29526521.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-between-adverse-childhood-experiences-and-functional-seizures-among-fnd-patients-in-the-fnd-patient-registry/