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Psychosomatic Disorders and Their Treatments / Traumatic Brain Injury Research · Journal article
Frontiers in Psychiatry · July 31, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a descriptive case series of six young women in an Ethiopian rehabilitation center with clinically suspected functional/dissociative seizures, identified without video-EEG confirmation and analyzed thematically for neuropsychiatric, trauma, and cultural features. The study is exploratory and hypothesis-generating; the authors acknowledge that confirmation in larger, electrophysiologically supported studies is needed.
Single-center case series with thematic analysis. Six young women, aged 18–24 years (median 20), with clinically suspected functional/dissociative seizures identified during routine care in a single women's residential rehabilitation center in Addis Ababa, Ethiopia.. Intervention: Clinical formulation and assessment using positive seizure-like episode features, psychiatric assessment, trauma history, cultural attributions, and staged diagnostic framework; treatment as delivered in routine care.. n = 6. Single center in Addis Ababa, Ethiopia.
Six young women, median age 20 years (range 18–24), with clinically suspected FDS identified in routine care Seizure-like episodes exhibited prolonged duration, irregular or asynchronous motor activity, preserved or fluctuating awareness, and limited recall without postictal confusion All cases showed psychiatric comorbidity including depression, anxiety, self-harm, substance use, and suicidality
All cases showed psychiatric comorbidity including depression, anxiety, self-harm, substance use, and suicidality
In resource-limited settings without access to video-EEG, clinicians should maintain clinical suspicion for FDS, conduct trauma-informed psychiatric assessment, screen for suicide risk, and treat comorbid conditions; however, this small exploratory series cannot guide diagnostic or therapeutic practice without confirmation.
Single-center case series of six patients without electrophysiological confirmation, generating hypotheses about FDS presentation in an under-resourced setting rather than establishing efficacy or firm diagnosis.
As stated by the source record.
Quoted from the source exactly as published.
In resource-limited settings without access to video-EEG, clinicians should maintain clinical suspicion for FDS, conduct trauma-informed psychiatric assessment, screen for suicide risk, and treat comorbid conditions; however, this small exploratory series cannot guide diagnostic or therapeutic practice without confirmation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background Functional/dissociative seizures (FDS; previously termed psychogenic non-epileptic seizures, PNES) are disabling functional neurological events associated with trauma, dissociation, psychiatric comorbidity, impaired functioning, and increased mortality. In sub-Saharan Africa, limited access to video-electroencephalography (video-EEG), limited specialist services, and culturally embedded explanatory models complicate recognition and treatment. To our knowledge, there are no published Ethiopian case-based studies of FDS employing structured clinical formulation and thematic analysis. Methods We present six young women, aged 18–24 years (median 20), identified during routine care in a residential rehabilitation setting in Addis Ababa with clinically suspected FDS. Because video-EEG was unavailable, cases were formulated using positive seizure-like episode features, psychiatric assessment, trauma history, cultural attributions, applying the staged diagnostic framework proposed by LaFrance et al. Treatment response was recorded as a clinical outcome and was not used as diagnostic evidence. The de-identified case narratives were analyzed using framework-based thematic analysis informed by Braun and Clarke, organized around a multidisciplinary model spanning neurobiology, trauma and attachment, dissociation, cultural psychiatry, and structural violence. Results Episodes exhibited features consistent with clinically suspected FDS: prolonged duration, irregular or asynchronous motor activity, forced eye closure or side-to-side head movements in some cases, preserved or fluctuating awareness, sensory prodrome in one case, limited recall, absence of postictal confusion, and emotional or interpersonal triggers. Psychiatric features included depression, anxiety, self-harm, substance use, khat-related arousal, nightmares, and suicidality. Trauma and attachment-related vulnerabilities included parental abandonment, maternal rejection, sexual abuse, family-arranged child marriage, homelessness, restricted socialization, estrangement, and separation from a child. Five overarching themes were identified: (1) neurological episode features; (2) betrayal and attachment disruption; (3) dissociation and functional shutdown; (4) psychiatric risk and comorbidity; and (5) culture, gender, and systemic invisibility. Conclusion Clinically suspected FDS was identified in young women at a single Ethiopian rehabilitation center and may be under-recognized in comparable settings. These single-center observations are hypothesis-generating and require confirmation in larger studies with electrophysiological support. In settings where video-EEG is unavailable, culturally adapted screening, trauma-informed assessment, suicide risk evaluation, treatment of psychiatric comorbidity, and clear referral pathways are urgently needed.
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