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What are non-epileptic seizures (PNES)?

Seizures are episodes of a temporary loss of control that may involve convulsions, change in consciousness or both. Epileptic seizures are caused by abnormal electrical firing in the brain.

Non-epileptic seizures are events that can look like epileptic seizures but they are not caused by abnormal electrical firing in the brain. The symptoms are real. These events cannot be controlled by the people who have them. Other terms for PNES include:

  • pseudo-seizures

  • psychogenic spells

  • attacks or events.

One in 5 patients referred for epilepsy testing have PNES. It is most common among adolescents and young adults, but can affect anyone. PNES is most commonly mistaken for epilepsy.

Symptoms

PNES can look like seizures. Someone might shake or fall down during an attack. There might be staring spells or other symptoms similar to epileptic seizures. Your provider may suspect you have PNES based on the details of your symptoms. You might be asked to describe:

  • triggers

  • types of movements

  • length of events

  • how often they happen.

Diagnosis

One aim of testing is to rule out epilepsy. The best way to diagnose PNES is by using video-EEG (electroencephalogram). This records electrical activity in the brain. Testing may take hours or days until seizure-like symptoms occur. 

Causes

Non-epileptic attacks do not have a known physical cause. PNES, unlike epileptic seizures, are not caused by a brain disease. Instead, the events are stress-induced. They may occur because of past traumatic events. Such events can produce physical symptoms in people without physical illness. 

Extreme emotional stress can cause physical illness. Most people can recall blushing when feeling embarrassed or feeling sweaty palms and faster heart rate as part of a “stage fright” reaction. Through ongoing research, we know that more extreme emotional stresses can actually cause physical illness.

Treatment

Medicines often used for epilepsy do not control  PNES. Studies show that therapy, lowering stress, and personal support reduce or stop the seizure-like symptoms. Mental health professionals are best prepared to provide treatment. This could include psychiatrists, psychologists and clinical social workers. Some people believe that this is a sign of being “crazy.” This is not the case. These events are not caused on purpose. With proper treatment 70% of adults stop having PNES.

Websites for More Information

Epilepsy Foundation: http://www.neurosymptoms.org/

References

  1. Epilepsy Foundation (n.d.). Nonepileptic Seizures or Events. Retrieved from

  2. Benbadis SR, Heriaud L. (n.d). Psychogenic (non-epileptic) seizures, A guide for families & patients. 

    Retrieved from http://hsc.usf.edu/COM/epilepsy/-PNESbrochure.pdf