Dissociation in epilepsy: rethinking boundaries between psychiatry and neurology
Epilepsy & Behavior April 2, 2026 Mathieu Dhoisne, Philippe Derambure, Arnaud Leroy
Dissociation—a disruption in the coherent integration of experience—is a frequent but overlooked feature in epilepsy, manifesting during seizures and between them. Evidence, though limited, suggests dissociation and epilepsy may best be conceptualized as interacting conditions shaped by shared neurobiological substrates, common risk factors, and reciprocal effects. Contributors may include disruptions in large-scale brain networks involved in embodiment, sensory integration, agentivity, emotional regulation, and perception, as well as seizure-related trauma, chronic stress, and the psychosocial burden of epilepsy. The authors advocate for improved assessment, interdisciplinary models, and targeted research to clarify underlying mechanisms, arguing that recognizing the bidirectional relationship challenges traditional disciplinary boundaries.