Non-epileptic seizures (PNES) are involuntary events of a brief loss of control. This may involve changes in behavior, movement, and/or senses. People who have these events might not be aware they are having them.

Other terms for PNES include:

• Functional seizures

• Pseudo-seizures

• Psychogenic spells

• Attacks or events

Epilepsy and epileptic seizures are caused by abnormal electrical firing in the brain. There is no abnormal electrical activity in the brain with PNES. The symptoms of PNES happen for other reasons.

PNES is often mistaken for epilepsy. Of the patients referred for epilepsy testing, 1 in 5 have PNES.

Symptoms

PNES can look like epileptic seizures. Someone might shake or fall during an attack. There might be staring spells or other symptoms that look like epileptic seizures. Your doctor will help you determine if you have PNES based on the details of your symptoms. You might be asked to describe:

• Triggers

• What your body does during an event.

• Whether you maintained awareness during the event.

• How long events last.

• How often they happen.

• What makes them stop.

Diagnosis

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

Causes

We do not fully understand the cause of these attacks. They are often described as an involuntary physical reaction to some kind of trigger, such as physical or psychological stress. They are more common in people with a history of traumatic events. People without a traumatic history can also experience PNES. Such events can produce physical symptoms in people without physical illness.

Extreme stress can cause physical illness. You may blush when embarrassed or have sweaty palms and faster heart rate as part of a “stage fright” reaction. PNES is one type of physical symptom some people have in response to their stressors.

Treatment

Medicines used to treat epilepsy do not control PNES. Learning more about your diagnosis can help reduce or stop these events. If you have any questions about PNES, talk to your doctor.

Treatment options include:

• Cognitive Behavioral Therapy

• Mental health counseling

• Lowering stress

• Personal support

Mental health providers are best prepared to provide treatment. This could include psychiatrists, psychologists, and clinical social workers. We have specially trained providers to assist with PNES. Up to 50% of people become event free after treatment. The goal of treatment is for people with PNES to maintain a meaningful degree of psychosocial engagement and function. This generally means to live life on your own terms whether you continue to have events or not.

Websites for More Information

Epilepsy Foundation

https://www.epilepsy.com

http://www.neurosymptoms.org