Perceptions and Emotions Toward Diets and Supplements Among Reddit Users With Functional/Dissociative Seizures and Their Caregivers: A Mixed-Methods Analysis of r/PNESsupport.

BACKGROUND

Functional/dissociative seizures (FDS) resemble epileptic seizures but occur without EEG abnormalities. Affected patients report fatigue and gastrointestinal symptoms, seeking dietary approaches. Yet, nutrition's role in FDS remains poorly understood. Thus, this mixed-methods study analyzed Reddit comments to explore patients' dietary perceptions and emotions.

METHODS

Comments from r/PNESsupport were collected using specific keywords. Only English-language comments from inception to September 2025 were included. After short and irrelevant comments were removed, the remaining comments were analyzed using sentiment analysis and reflexive thematic analysis. Analyses were performed using RStudio v2025.05.0 and R v4.3.3.

RESULTS

Thirty-one comments from 23 users with FDS (UwFDS) were analyzed. The total sentiment score was mildly positive (0.080 ± 0.116). Five themes with 12 subthemes emerged: (1) UwFDS emphasized stable blood sugar, noting hypoglycemia and meal timing as seizure triggers; (2) Ketogenic, low-carbohydrate, and elimination diets were reported as helpful yet raised concerns about hydration and nutritional adequacy; (3) UwFDS described cannabidiol oil, amino acid supplements, and avoiding artificial sweeteners as complementary measures; (4) Food sensitivities and gastrointestinal discomfort were linked to symptom exacerbation or relief; (5) Nutrition was framed as supporting quality of life alongside medical and psychological care.

CONCLUSION

The positive sentiment reflects hope and agency rather than metabolic efficacy. Integrating nutritional care within psychologically informed frameworks honors patient experience while preserving FDS's non-organic nature. Future research should evaluate whether structured nutritional guidance, embedded in psychologically informed care, improves outcomes and explore mechanisms like interoceptive processing and the gut-brain axis.