Psychogenic Nonepileptic Seizures

Overview

Definition

Psychogenic nonepileptic seizures (PNES) are seizure-like movements, sensations, or behaviors. PNES may seem similar to epileptic seizures. However, they have very different causes.

Causes

PNES is caused by mental health problems. This may include intense emotions, trauma, or stress. Other conditions like depression are also often present. It is not caused by problems with electrical signals in the brain.

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Risk Factors

Factors that may increase the risk of PNES include:

  • History of physical trauma, especially sexual trauma
  • A recent emotionally painful event like a divorce or the death of a loved one
  • Family history of epilepsy

Risk factors specific to children include:

  • Difficulties in school
  • Family conflict
  • Problem with others, such as bullying

SymptomsandDiagnosis

Symptoms

PNES symptoms may include:

  • Loss of consciousness
  • Staring
  • Shaking, uncontrollable muscle movement, and falling

PNES may differ from epilepsy in that PNES does not usually include:

  • Loss of bladder or bowel control
  • Confusion, headache, and fatigue that occurs after an epileptic seizure
  • Eyes that remain open
  • Inability to speak

Diagnosis

You will be asked about your symptoms and past health. The doctor will ask questions about the seizure. A physical exam will be done. You may be referred to a doctor that specializes in the nervous system and the brain.

The doctor may suspect PNES based on your responses. To rule out other types of seizures the doctor may order:

  • Blood tests and brain scans may be done. They can look for potential causes of seizures.
  • EEG—shows the electrical activity in the brain. PNES is confirmed if there is a seizure without a change in EEG.

Treatments

Treatment

Treatment is focused on the cause of PNES. Mental health problems may be treated with one or both of the following:

  • Medicine—for mental health, not for seizure itself.
  • Psychological therapy—to help cope with stressors, change thought patterns, and learn new behaviors. Types of therapy may include:
    • Psychotherapy
    • Cognitive-behavioral therapy
    • Group therapy

Prevention

There is no known ways to prevent PNES.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

a (Pseudoseizures)

RESOURCES

Citizens United for Research in Epilepsy (CURE)  http://www.cureepilepsy.org 

Family Doctor—American Academy of Family Physicians http://www.familydoctor.org 

CANADIAN RESOURCES

Epilepsy Canada  http://www.epilepsy.ca 

Health Canada  http://www.hc-sc.gc.ca 

References

LaFrance WC Jr, Reuber M, Goldstein LH. Management of psychogenic nonepileptic seizures. Epilepsia. 2013 Mar;54 Suppl 1:53-67

Non-epileptic seizures. Epilepsy Society website. Available at: https://www.epilepsysociety.org.uk/non-epileptic-seizures#.Vwe7rnpuN8E. Published July 2017. Accessed April 11, 2018.

Psychogenic nonepileptic seizures. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116939/Psychogenic-nonepileptic-seizures . Updated October 16, 2017. Accessed April 11, 2018.

The truth about psychogenic nonepileptic seizures. Epilepsy Foundation website. Available at: http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures. Accessed April 11, 2018.