An international study of the effects of the COVID-19 pandemic on characteristics of functional seizures

Ali A. Asadi-Pooya*, Eugen Trinka, Coraline Hingray, Ahmad Fawaz, Ioannis Karakis, Nirmeen A. Kishk, Mohsen Farazdaghi, Julia Höfler, Alexis Tarrada, Abdulaziz Ashkanani, Aida Risman, Haytham Rizk

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


We investigated whether the COVID-19 pandemic has affected the clinical characteristics of patients with functional seizure (FS) (at the time of diagnosis) in a large multicenter international study.

This was a retrospective study. We investigated all patients with FS, who were admitted at the epilepsy monitoring units at six centers in the world: 1. Shiraz, Iran; 2. Salzburg, Austria; 3. Nancy, France; 4. Atlanta, USA; 5. Kuwait City, Kuwait; and 6. Cairo, Egypt. Patients were studied during two time periods: admitted in 2018-2019 (pre-COVID era) and 2020-2021 (COVID era).

Three hundred and twenty-six patients were studied. Two hundred and twenty-four (68.7%) patients were diagnosed before and 102 (31.3%) persons during the COVID-19 pandemic. Only, a history of family dysfunction was significantly associated with the COVID-19 pandemic era (Odds Ratio: 1.925, 95% Confidence Interval: 1.099-3.371; p = 0.022). A low level of education might also be associated with FS during the COVID-19 pandemic, at least in some cultures (e.g., the Middle-East).

The COVID-19 pandemic has not affected the clinical characteristics of patients with FS (at the time of diagnosis). However, a history of family dysfunction was significantly more frequently associated with FS during the COVID-19 pandemic. Multiagency integration of law enforcement responses, social services, and social awareness are recommended to address family dysfunction and domestic violence and support the victims during this pandemic.
Original languageEnglish
Article number108530
Number of pages5
JournalEpilepsy and Behavior
Early online date29 Dec 2021
Publication statusPublished - Feb 2022


  • Coronavirus
  • Dissociative
  • PNES
  • Seizure

Fields of Science and Technology Classification 2012

  • 305 Other Human Medicine, Health Sciences

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