From Positive Sign to Self-Management: Real-Time Interruption Training in Functional Seizures

Functional seizures are diagnosed through positive clinical and electroclinical features, but translating diagnosis into immediate self-management remains challenging. We describe seven consecutive patients in whom an observed functional or suspected functional seizure was used to teach event interruption through alternating finger tapping and conversational attentional redirection, followed by box breathing for self-management. Habitual events lasted a median of 10 minutes (range 4-45). Six patients able to actively participate demonstrated interruption within approximately 15-60 s and subsequently self-interrupted events within 7 days, four within 48 hours. Real-time demonstration of symptom modifiability may translate a positive functional sign into an immediately actionable self-management strategy.