Psychogenic Nonepileptic Seizures

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.

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

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.

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.