To propose a neuroenergetic deficit syndrome as a potential mechanism for functional/dissociative seizures (FDS).
Approach:
Hypothesis Development: The hypothesis suggests that FDS may arise from episodic cerebral oxygen insufficiency combined with impaired neural network reorganization.
Evidence Review: The paper reviews existing literature and clinical observations that support the neuroenergetic deficit hypothesis.
Testable Predictions: Seven testable predictions related to the hypothesis are outlined for future research.
Key Findings:
FDS may involve a mismatch between local cerebrovascular oxygen delivery and metabolic demand.
The condition disproportionately affects females, with a noted shift in prevalence at puberty.
Existing psychological models do not adequately explain the biological mechanisms underlying FDS.
Interpretation:
The neuroenergetic hypothesis offers a perspective that complements existing cognitive and psychological models of FDS.
Limitations:
The hypothesis may not account for all presentations of FDS due to the disorder's clinical and aetiological heterogeneity.
Failure of the haemodynamic predictions would challenge the hypothesis but not the broader biopsychosocial framework.
Conclusion:
The neuroenergetic deficit syndrome is proposed as a potential mechanism contributing to FDS, warranting further investigation.
