The formal definition of Psychogenic non-epileptic seizures are attacks that look like epileptic seizures, but are not caused by abnormal electrical discharges.
But they are so much more…
Formally known as Pseudo-Seizures - they are the most common condition misdiagnosed as epilepsy.
Instead caused by stress that is psychological or emotional these attacks mimicking a seizure can be very debilitating for patients and confusing for the medical team and the patient’s family.
The EEG is of great importance in diagnosing this condition since capturing an episode can help the physician effectively rule out a seizure.
Often a routine EEG is not enough data to pinpoint this condition due to the limited amount of data in a routine study.
A long term study (1-3 days) often will be more effective and increase the likelihood of capturing a spell.
Since PNES is not caused by abnormal brain activity the EEG recording during these episodes is normal.
The accuracy of diagnosis is critical to a person receiving the correct treatment.
The treatment of PNES is focused on addressing the underlying psychological problem. A patient with PNES will not respond to treatment with anti-seizure medication; actually some anti-seizure medications can make it worse.
Some possible contributors to a person developing PNES:
A history of mood disorders
Anxiety
Dissociative disorders
Post-traumatic stress disorders
History of physical, emotional, or sexual abuse
Family stressors or conflict
Psychosis
Personality disorders
Attention problems
History of traumatic brain injury
Substance abuse
Behavioral disturbances (anger, aggression, withdrawal)
These disorders are seen frequently in people diagnosed with PNES.
It’s important to find a mental health provider with a good understanding of PNES and it’s unique challenges.
However, often the Neurodiagnostic laboratory is their first point of contact so recording a good quality study that is long enough to capture the data needed is essential.
For more information, click here to visit the Epilepsy Foundation site for an overview video and more information about the causes of Psychogenic Non-Epileptic Seizures.
Roya Tompkins, MS, R. EEG/EP T, RPSGT
Resources:
Epilepsy Foundation
Cleveland Clinic
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