Evaluate the impact of a multidisciplinary treatment program on seizure frequency, symptom severity, and psychological wellbeing in patients with nonepileptic seizures (NES).

NES affect 1.4 to 4.9 per 100,000 annually, with healthcare costs exceeding $1.2 billion in the U.S. Delays in diagnosis—up to 7 years—lead to unnecessary treatments and increased mortality. Despite ongoing research, optimal NES treatment remains unclear. The NEST clinic at Rush University offers a multidisciplinary evaluation followed by an outpatient, manualized, mindfulness-based therapy to address NES symptoms.

Records of patients treated at the NEST clinic from 05/01/2021 to 01/01/2024 were reviewed. All patients underwent an initial evaluation by a neurologist, psychiatrist, therapist, and social worker followed by a 12-session treatment program. Outcome measures included reduction in seizure frequency, seizure remission, reduction of antiseizure medications (ASM), and satisfaction with the program.

76 patients (mean age 39.83, SD 13.18 years) were evaluated; 78.9%(60) identified as female, 15%(12) as male, and 5%(4) as non-binary. Median NES symptom duration was 41 months (IQR 16-96). Referrals came from general neurology (44.1%) and epilepsy specialists (29%). 29% had suspected comorbid epilepsy. The full NEST program was offered to 76%(55) of patients. Among participants, 60%(34) had >50% seizure reduction, including 21%(12) reporting no seizures at the last visit. ASM was reduced in 17.3%(9) of patients. 92%(48) reported benefit, and 84%(44) re-engaged in meaningful activities. Seizure reduction was independent of age, gender, seizure onset, and coexisting epilepsy.

A multidisciplinary intervention followed by mindfulness-based therapy can reduce seizure frequency and ASM use in NES patients. A high proportion (92%) reported benefits, even without full seizure freedom, allowing persons living with NES to re-engage in meaningful social activities improving wellness and quality of life.