B-167: An Integrated Multidisciplinary Care Model for Functional Seizures: The Role of Neuropsychology in Diagnosis, Education, and Treatment

Abstract

Objective: Functional seizures (psychogenic non-epileptic seizures; PNES) are associated with high healthcare utilization, delayed diagnosis, and difficulty engaging treatment. We describe how the role of neuropsychologists in a multidisciplinary PNES clinic can improve diagnostic understanding and treatment engagement. Method/Data Selection: We outline the role of neuropsychologists within a multidisciplinary team integrating neurology, neuropsychology, and psychotherapy services. Patients undergo neurological evaluation to establish diagnosis, followed by psychodiagnostic assessment and feedback. Feedback provides a brain-behavior-based explanation of symptoms, identifies personal strengths and highlights contextual factors maintaining symptoms. Patients are referred toward evidence-based psychological interventions. Programmatic metrics derived from routine clinical care are reported. Results/Data Synthesis: Between 2017-2026, 382 patients evaluated for PNES were reviewed as a multidisciplinary team – neuropsychologists, neurologists, epilepsy fellows, and neuropsychology interns. Patient's mean age was 38.5 years (SD = 14.2) and 70% identified as female. Average duration of symptoms prior to evaluation was 5.9 years (SD = 7.2). Of these patients, 168 were contacted for psychodiagnostic assessment (85 completed; 83 declined), 189 were referred elsewhere. Separately 25 were reviewed for educational purposes only. The average time to evaluation was 4.5 months (SD = 10.4). Following feedback, 11% initiated psychotherapy within the clinic, while most were referred to or continued with trained community providers. Patients who began treatment in clinic attended at least six sessions. Qualitatively, patients reported improved understanding and greater confidence in their treatment plan. Conclusions: Multidisciplinary care models may reduce fragmentation and improve engagement in services, while assessment feedback appears to bridge diagnosis and treatment by enhancing understanding, reducing stigma, and facilitating psychotherapy.