Functionality of symptoms and interpersonal communication in home video recordings of functional/dissociative versus epileptic seizures

Home video analysis captures important contextual and behavioral features of FDS and ES. The differential diagnostic reliability of lay raters' perceptions is limited. Findings suggest that FDS comprise passive rather than active appellative communication, likely reflecting emotional regulation processes. In contrast, in the home videos studied, ES patients exhibit greater postictal awareness and interaction than FDS patients, pointing to the relevance of the postictal phase for discriminating both seizure types. The results emphasize integrating environmental context and patient-caregiver interactions before, during, and after seizures to understand the functional significance of FDS in naturalistic, nonclinical settings.