159: Key Practice Takeaways From the New AAN Functional Seizure Guidelines

Welcome to the NeurologyLive® Mind Moments® podcast. Tune in to hear leaders in neurology sound off on topics that impact your clinical practice.In this Mind Moments episode, Benjamin Tolchin, MD, MS, FAAN, joins the podcast to provide clinical perspective on the recently published American Academy of Neurology (AAN) guidelines on functional seizures, drawing on his role as a contributing author to the recommendations. Tolchin, Director of the Center for Clinical Ethics at Yale New Haven Health and Associate Professor of Neurology at Yale School of Medicine, discusses what prompted the development of the first AAN guideline in this space and how the evidence base evolved to support formal recommendations. The conversation explores key considerations around diagnosing functional seizures, including history, semiology, EEG use, and the growing role of video documentation. Tolchin also addresses how clinicians should approach psychiatric comorbidities and co-occurring epilepsy, the evidence supporting psychological interventions, why pharmacologic therapies are not recommended for functional seizures themselves, and where major gaps remain in research to advance care in the years ahead.Looking for more Epilepsy discussion? Check out the NeurologyLive® Epilepsy clinical focus page.Episode Breakdown: 1:10 – Why growing evidence prompted the first AAN guideline on functional seizures 3:20 – Diagnostic priorities including history, semiology, EEG, and video documentation 6:15 – Assessing psychiatric comorbidities and co-occurring epilepsy in functional seizures 9:15 – Neurology News Minute 11:30 – Evidence supporting psychotherapy for functional seizures 14:50 – Pharmacological evidence and use of antiseizure medications for functional seizures 18:35 – Barriers to advancing clinical trials in functional seizures 22:05 – Research priorities to refine treatment and long-term outcomes The stories featured in this week's Neurology News Minute, which will give you quick updates on the following developments in neurology, are further detailed here: FDA Approves Subcutaneous Copper Histidinate as First Treatment for Pediatric Menkes Disease sBLA Acceptance Positions Efgartigimod as Potential First Therapy for Seronegative Myasthenia Gravis High-Dose Nusinersen Gains European Commission Approval for Spinal Muscular Atrophy Thanks for listening to the NeurologyLive® Mind Moments® podcast. To support the show, be sure to rate, review, and subscribe wherever you listen to podcasts. For more neurology news and expert-driven content, visit neurologylive.com.