What is an "Episode"?
In FND, an episode refers to an acute flare-up of symptoms that temporarily impacts a person's ability to move, speak, or remain conscious. These can range from functional seizures (PNES) to sudden-onset weakness or paralysis.
Immediate Safety First
The primary goal during an episode is safety. You cannot stop an FND seizure or paralysis episode with force; you must wait for the brain to finish its "software reset."
Seizure (PNES) Protocol
If someone is experiencing a functional seizure, follow these steps:
- Clear the Space: Remove any sharp objects nearby. Place something soft under the head if they are on the ground.
- Stay Present: Do not leave the person alone. Your calm presence is a safety signal to their nervous system.
- Minimize Stimuli: Turn down loud music or bright lights. Reduce the number of people in the immediate vicinity.
- Wait it Out: Most episodes resolve within 5-15 minutes. Record the duration but do not attempt to wake the person up aggressively.
Do Not Use Restraint
Managing Sudden Paralysis
When a person suddenly loses the ability to move a limb or speak:
Use Distraction
Engage the person in a simple task that redirects their focus, like counting backward or describing objects in the room.
Reassure
Remind them that their brain is healthy and that this is a temporary signaling issue that will pass.
Post-Episode Care
After an episode finishes, the person may be extremely fatigued, confused, or emotional.
- Allow for a "low-stimulus" recovery period (dark room, quiet).
- Do not immediately analyze the episode; wait until they are fully recovered.
- Ensure they have water and a comfortable place to rest.