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Title:Mortality in functional seizures : evidence from a large electronic health records dataset
Authors:ID Kanaan, Richard A. (Author)
ID Berlot, Rok (Author)
ID Pollak, Thomas A. (Author)
ID Reuber, Markus (Author)
ID Popkirov, Stoyan (Author)
Files:.pdf PDF - Presentation file, download (521,08 KB)
MD5: 8E29FE3E408FEDF185C9BEF4CD9E92F0
 
URL URL - Source URL, visit https://onlinelibrary.wiley.com/doi/10.1002/epi.70230
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo UKC LJ - Ljubljana University Medical Centre
Abstract:Objective: Several studies have found that people with functional seizures (FS) have increased mortality, approaching that of epilepsy (epileptic seizures [ES]). The small numbers of deaths in these studies make it unclear whether they can be attributed to comorbidities. We used a very large electronic health database to compare mortality in FS and ES, controlling for comorbidity. Methods: We searched the TriNetX database for people with FS and no ES, people with ES and no FS, and people with neither FS nor ES (NS). We compared mortality while controlling for demographics and comorbid conditions. Results: We identified 1 916 787 people with ES, 32 854 people with FS, and 21 053 667 healthy controls. FS had rates of mental and physical comorbidities that were higher than NS and, for most categories, higher than ES. The risk of death (hazard ratio [HR]) in ES compared to FS was 2.99 (95% confidence interval [CI] = 2.81-3.18), which was reduced to 2.07 (95% CI = 1.92-2.24) when matched for 31 demographic and health factors. The risk of death in NS compared to FS was .56 (95% CI = .53-.59); after matching for demographics and mood disorders, this was .48 (95% CI = .44-.53). Matched sensitivity analyses suggest this was particularly pronounced in the year following diagnosis (HR = .39, 95% CI = .33-.47) and in the 5th decade of life (HR = .38, 95% CI = .27-.52). Significance: FS confers approximately doubled mortality over that conferred by its comorbidities, although still only half of that conferred by ES, most prominently after diagnosis and in early middle age.
Keywords:etiology, functional neurological disorder, mechanism, nasology
Publication status:Published
Publication version:Version of Record
Year of publishing:2026
Number of pages:str. 3709-3718
Numbering:Vol. 67, issue 7
PID:20.500.12556/DiRROS-31304 New window
UDC:616.8
ISSN on article:1528-1167
DOI:10.1002/epi.70230 New window
COBISS.SI-ID:281908995 New window
Note:Nasl. z nasl. zaslona; Opis vira z dne 17. 6. 2026;
Pub. date in DiRROS:27.07.2026
Views:170
Downloads:145
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Record is a part of a journal

Title:Epilepsia
Shortened title:Epilepsia
Publisher:Blackwell Science Inc.
ISSN:1528-1167
COBISS.SI-ID:515019545 New window

Document is financed by a project

Funder:Other - Other funder or multiple funders
Funding programme:UK Medical Research Council
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Funder:WT - Wellcome Trust
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Name:/

Funder:NHMRC - National Health and Medical Research Council
Funding programme:National Health and Medical Research Council (NHMRC)
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Name:/

Funder:Other - Other funder or multiple funders
Project number:-
Name:Medical Research Future Fund
Acronym:MRFF

Funder:Other - Other funder or multiple funders
Funding programme:Weary Dunlop Foundation
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Name:/

Funder:Other - Other funder or multiple funders
Funding programme:Victorian Government
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Name:/

Funder:ARIS - Slovenian Research and Innovation Agency
Project number:P1-0389-2022
Name:Medicinska fizika

Funder:Other - Other funder or multiple funders
Funding programme:National Institute for Health and Care Research, Health and Social Care Delivery Research
Project number:/
Name:/

Funder:Other - Other funder or multiple funders
Funding programme:Epilepsy Research UK
Project number:/
Name:/

Funder:Other - Other funder or multiple funders
Funding programme:German Federal Ministry of Research, Technology and Space
Project number:01EO2104
Name:Advanced Clinician Scientist Programme
Acronym:UMEA2

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

Language:Slovenian
Keywords:etiologija, funkcionalna nevrološka motnja, mehanizem, nozologija


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