Functional seizures (FS), formerly known as psychogenic non-epileptic seizures (PNES), are paroxysmal behavioral modifications that resemble epileptic seizures clinically. However, their neurobiological origin differs as they are not associated with electrophysiological epileptic discharges [1]. They are classified as a dissociative disease by the International Classification of Diseases (ICD-11), while the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes them as a functional neurological disorder. The prevalence of FS ranges from two to 33 per 100,000 in the general population (making it as common as Parkinson's disease or multiple sclerosis) and is likely as high as 10 to 20% in patients monitored for drug-resistant epilepsy [2]. Although some symptoms may differ between FS and epileptic seizures, patient interviews are often poor [3] and witnesses’ descriptions are not always reliable [4], [5]. As a result, definitive diagnosis remains challenging and is typically obtained by recording typical seizures during video-electroencephalogram (video-EEG) assessments [6].

Compared to patients with epilepsy, individuals with FS experience lower quality of life (QoL) [7], [8]. Additionally, they are more likely to have post-traumatic stress disorder (PTSD), a history of sexual abuse or violence [9], personality disorders, anxiety, and depression [10]. These psychiatric comorbidities are considered major factors contributing to the impairment of QoL in patients with FS, although this still needs to be confirmed [11]. To gain a better understanding of the factors associated with QoL in patients with FS, we prospectively included patients diagnosed with FS at the Clinical Neurosciences Department of Bordeaux University Hospital. Our main objective was to determine the proportion of patients with clinically significant improvement (an increase of 11.8 points or more) in the overall QoL score, assessed using the Quality of Life in Epilepsy-31 (QOLIE-31) self-questionnaire, at six months after diagnosis.