What to do during a functional (dissociative) seizure?

What is a functional seizure, exactly?

A functional seizure – also called a dissociative or non-epileptic seizure – is a seizure in which control over the body and consciousness is temporarily lost. This can look like shaking, stiffening, jerking or “zoning out”. Unlike an epileptic seizure, it is not caused by an abnormal electrical discharge in the brain – the brain is structurally intact, its coordination just briefly falls out of step.

Two things are crucial to understand. First, the seizure is involuntary. No one does this on purpose, no one can stop it by willpower – just as one cannot switch off blushing or hiccups. Second, it is not dangerous to the brain: even a longer-lasting functional seizure leaves no damage. And it is treatable – with the right therapy, around half of those affected become seizure-free. You can read more about what happens in these moments under “Understanding dissociation”.

How to help in the moment – step by step

1. Stay calm. Your composure is contagious. Panic in the room can prolong or intensify the seizure.
2. Make the surroundings safe. Move hard or sharp objects out of the way and, if needed, place something soft under the head. Do not force the person into a position and do not restrain their movements.
3. Reduce stimulation. Kindly ask bystanders to keep their distance. Less noise, fewer eyes, less commotion – this helps the nervous system to settle again.
4. Speak calmly and kindly. In a quiet voice, say that the person is safe and that it will pass. Even someone who cannot answer often perceives a reassuring voice. Some people find it helps to arrive gently in the here and now – for instance to hear their own name or to notice where they are.
5. Give it time. The seizure ends on its own. There is nothing to “interrupt” – patience is exactly right.
6. Afterwards: the recovery position, once the movements have stopped and the person is not yet fully responsive. Stay until they are completely present again.

What you had better not do

• Do not hold down or forcibly stop the movements – this can increase fear and tension and lead to injury.
• Put nothing in the mouth – no spoon, no finger, no drink. The idea that one could “swallow the tongue” is a myth; an object in the mouth is more likely to cause injury.
• No emergency medication (e.g. benzodiazepines), such as is intended for a prolonged epileptic seizure. For functional seizures this is usually not needed and can do harm.
• Do not shake, wake or shout. That is no way back – it only increases the stress.
• No crowd. Many onlookers and excitement can prolong the seizure.

When you should call the emergency services (112)

If it is reliably known that these are functional seizures, then even a longer seizure is not dangerous, and an emergency call is usually not necessary. In these situations, however, you should call 112:

• It is the first seizure or the cause is unclear.
• The person has seriously injured themselves or is not breathing normally.
• An epileptic seizure cannot be ruled out – for instance because epilepsy is also known and the seizure runs atypically.
• You are unsure. When in doubt, always get help.

An important note for emergencies: when the emergency team arrives, it helps a great deal to tell them that functional (dissociative) seizures are known. This can avoid unnecessary and distressing measures – such as strong medication or ventilation. An emergency card or a short note in the wallet/phone (“I have functional/dissociative seizures. No emergency medication needed. Please keep me safe and wait calmly.”) can be worth its weight in gold in such a moment.

After the seizure

When the seizure is over, many people need time to fully come back – they are often exhausted, confused or embarrassed. What helps now: be calmly present, give time, gently reorient (“You are at home, everything is fine”). What does not help: reproaches, pressure or phrases like “pull yourself together”. The seizure was involuntary – shame is completely unnecessary, but common. A simple “I’m here, take your time” helps more than any question.

Read on

Sources

1. Stone J, et al. Functional (Dissociative) Seizures – patient information. neurosymptoms.org (accessed 2026).
2. Epilepsy Action (British Epilepsy Association). Dissociative seizures (non-epileptic attack disorder / NEAD) – first aid & support. epilepsy.org.uk (accessed 2026).
3. Deutsche Hirnstiftung. Dissoziative Anfälle: Symptome, Ursachen und Behandlung. hirnstiftung.org (accessed 2026).
4. Deutsche Epilepsievereinigung e. V. Leaflet “Dissoziative, nicht epileptische Anfälle” (2024).
5. Goldstein LH, Robinson EJ, Mellers JDC, et al. Cognitive behavioural therapy for adults with dissociative seizures (CODES): a pragmatic, multicentre, randomised controlled trial. The Lancet Psychiatry. 2020;7(6):491–505. doi:10.1016/S2215-0366(20)30128-0. PMID 32445688.
6. Espay AJ, Aybek S, Carson A, et al. Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders. JAMA Neurology. 2018;75(9):1132–1141. doi:10.1001/jamaneurol.2018.1264. PMID 29868890.
7. Deutsche Gesellschaft für Neurologie (DGN). S2k guideline “Functional Movement Disorders”, AWMF register number 030/148, 2026.

This article provides general information and does not replace medical advice. If you or someone close to you has functional seizures, please discuss an individual emergency plan with a doctor experienced in FND or epilepsy.

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