Non-epileptic attack disorder (NEAD) is a key condition to distinguish from epilepsy. This review examines clinical research on consciousness during non-epileptic attacks (NEAs) and places it within recent neuroscience and philosophy of mind debates. The authors argue that studies should differentiate between 'level' and 'content' of consciousness, as well as between 'phenomenal consciousness' and 'access consciousness'. Evidence shows great variability in NEA experiences, but in most attacks, phenomenal experience and vigilance are reduced less than in epileptic seizures involving consciousness impairment. Complete loss of consciousness is the exception, not the rule, and both patients and observers may overestimate consciousness impairments during seizures.
The explanatory gap between brain processes and phenomenal consciousness may be resolvable if consciousness is understood as a non-intrinsic, description-dependent property. The author argues that neither current neuroscience nor philosophy alone can bridge this gap, but that new neuroscientific descriptions could change the features of consciousness itself, making the gap disappear. Neuroscientists should continue studying neural correlates of consciousness rather than trying to refute the gap argument.