A seizure is an event where you lose control of your body, convulse, and may lose consciousness. There are two types: epileptic and nonepileptic. Psychological issues can also cause ‘pseudoseizures,’ which don’t up on an EEG but can feel very real.
The brain disorder epilepsy causes the first type. Epilepsy disrupts the nerve activity in the brain, resulting in seizures. You can tell that a seizure is epileptic if brain electricity monitoring shows neurons misfiring during the event.
Nonepileptic seizures are caused by something other than epilepsy. Although psychological conditions are the most common cause of nonepileptic seizures, medical conditions such as convulsive syncope (fainting plus jerking) or low blood sugar may also cause nonepileptic seizures.
Nonepileptic seizures are fairly common. According to a 2013 literature review,
If a seizure is caused by a psychological condition, there will be no evidence of atypical activity on an electroencephalogram (EEG). These types of seizures are sometimes called:
- psychogenic nonepileptic seizures (PNES)
- “pseudoseizures,” which is an outdated term
On ‘pseudoseizures’Medical professionals previously referred to PNES as “pseudoseizures.” This term is outdated and not generally preferred by neurologists.
“Pseudo” is a Latin word meaning false. However, nonepileptic seizures are as real as epileptic seizures and are not consciously or purposefully produced.
People who experience nonepileptic seizures have many of the same symptoms as people with epilepsy:
- convulsions, or jerking motions
- stiffening of the body
- falling
- loss of attention
- staring
People who experience PNES often have mental health conditions, too. For this reason, you may also have symptoms associated with trauma.
Because PNES is usually a physical manifestation of psychological distress, there are a lot of possible causes.
These commonly include:
- sexual or physical abuse
- traumatic brain injury
- personality disorders, such as:
- types of psychosis, such as schizophrenia
- dissociative disorders
- affective disorders, also known as mood disorders
- post-traumatic stress disorder (PTSD)
- attention deficit hyperactivity disorder (ADHD)
- anxiety
- substance use disorder
- family conflict
- anger management issues
Risk factors
According to a 2019 study, people assigned female at birth are
PNES also tends to affect people
People with PNES are often misdiagnosed with epilepsy. This is because a doctor is not there to witness the event.
The best diagnostic test is a video EEG. During this test, you’ll stay at a hospital or specialty care unit. You’ll be recorded on video and monitored with an EEG. EEG monitoring may sometimes be performed at home as well.
This test will show if there are any atypical characteristics in your brain’s functioning during the seizure. If the EEG comes back normal, you might have nonepileptic seizures. To confirm this diagnosis, neurologists will also watch the video of your seizure.
Many neurologists also work with psychiatrists to confirm a diagnosis. A psychiatrist will talk with you to help determine if there are psychological reasons that could be causing your nonepileptic seizures.
There’s no one specific treatment for PNES that will work for every person. Determining the cause is a significant part of treatment.
The most effective treatment methods include:
- individual counseling
- family counseling
- behavioral therapy, such as relaxation therapy
- cognitive behavioral therapy (CBT)
- eye movement desensitization and reprocessing (EMDR)
Counseling or therapy can occur at an inpatient facility or as an outpatient method. Psychiatrists, psychologists, and social workers can administer therapy.
Antiepileptic drugs do not help nonepileptic seizures, such as those caused by PNES. But medication for mood disorders may be a viable treatment.
If you received a diagnosis of epilepsy but are not responding to antiepileptic drugs, you may be experiencing nonepileptic seizures. If this is the case, contact a doctor and possibly a mental health professional.
Getting a correct diagnosis is the first step toward getting well.