Healthcare professional education on functional neurological symptoms and experiences of managing functional seizures during pregnancy: a scoping review and empirical study

Abstract

lnterest in funclional neurological symploms (FNS) has increased in recent years, particularly regarding their diagnosis, management, and treatment. Yet, little is known about how heallhcare professionals (HCPs) are educated about these conditions or how this knowledge is applied in practice, especially in complex contexts such as pregnancy. This paper brings together findings from a scoping review of FNS education and an empirical study exploring HCPs experiences of managing patients with functional seizures (FS in pregnancy. The scoping review, conducted according to Arksey and O'Malley's framework and the PRISMA-ScR checklist, systematically mapped 18 studies from five databases. Results indicated marked variability in the scope and delivery of FNS teaching, with content on specific symptoms typically confined to neurology focused training. Teaching methods commonly included didactic, role-play, and video-based activities. but there was little consensus on evaluation approaches, highlighting gaps in standardisation and best practice.

Complementing this, the empirical study used semi-structured interviews with 12 HCPs from neurology, obstetrics, and maternity care to explore experiences of caring for women with FS during pregnancy. Reflexive Themalic Analysis identified four themes capturing the clinical and emotional challenges of managing FS in the context of uncertainty, as well as the pressing need tor clearer guidance and greater support for both HCPs and patients.

Together, the review and empirical findings underscore the fragmented nature of FNS education and the difficulties HCPs face when navigating complex clinical scenarios. Addressing these gaps requires more consistent and comprehensive training, alongside targeted research to inform evidence-based practice.

Thesis is embargoed until 31 December 2026.

Date of Award	Dec 2025
Original language	English
Awarding Institution	Queen's University Belfast
Supervisor	David McCormack (Supervisor) & Nigel Lyttle (Supervisor)