Psychogenic Non-Epileptic Seizures

Dissociative, “pseudoseizures”, or psychogenic non-epileptic seizures (PNES) are sudden, involuntary episodes that may resemble epileptic seizures, but don’t have abnormal electrical activity in the brain.

Psychogenic seizures originate from psychological factors; they often arise from stress and, in some cases, trauma. They are part of a family of disorders called functional neurological disorders.

The better patients understand the symptoms of non-epileptic seizures, the easier it is to diagnose and treat them. That’s why in this blog we provide an overview of the most common symptoms and some insights on how to manage this condition.

Recognizing Dissociative Seizures

Non-epileptic seizures can manifest in various ways, making them challenging to distinguish from epileptic seizures. However, certain characteristics can help identify them:

Physical Symptoms

• Convulsions : These can resemble those observed in epileptic seizures but usually involve more exaggerated movements.
• Unresponsiveness : The patient appears unconscious or unresponsive during the whole episode.
• Limb weakness : A patient may sometimes develop temporary or even partial paralysis of one or more limbs.
• Eye Movements : Unlike epileptic seizures, non-epileptic seizures may involve more controlled eye movements, such as closing the eyes tightly.

Emotional and Behavioral Symptoms

• Sudden Emotional Distress: Episodes may be precipitated by a stressful event or emotional upset, often in the absence of an apparent physical cause.
• Behavioral Change: The seizure may be accompanied by unusual behavior, such as crying, shouting, and other emotional disturbances.
• Memory Problems: post-seizure amnesia and confusion regarding the event are also common.

Circumstantial Triggers

• Stressful Events: Any situation that involves very high stress or unresolved trauma may cue non-epileptic seizures.
• Fatigue and sleep deprivation: Lack of sleep and tiredness can increase the possibility of an attack.
• Emotional Onset: Internal conflicts or emotional distress could trigger seizures.

Differentiating Non-Epileptic from Epileptic Seizures

Although non-epileptic seizures may share some similarities with epileptic seizures, they differ in the following key features:

• Duration and Course Onset: Non-epileptic seizures generally last longer and have an onset and offset that is more insidious compared with epileptic seizures.
• Treatment Response: Non-epileptic seizures are characteristically resistant to antiepileptic drugs as these medications treat a different underlying cause.
• Electroencephalogram (EEG) findings: The EEG is often normal and usually does not show the characteristic seizure activity of epilepsy.

Managing Dissociative Seizures

An effective approach to managing non-epileptic seizures addresses the following factors:

• Psychotherapy: Cognitive-behavioral therapy and other psychotherapies aid patients in learning about and controlling triggers and stressors.
• Stress Management: The application of mindfulness, meditation, and relaxation exercises would help in the reduction of seizures.
• Support Systems: Friends, family, and health personnel play an important part in supporting the individual both emotionally and in the physical aspects of his life.
• Regular Monitoring: Continuous surveillance with health workers provides the best possible choice for the mode of therapy and management at critical points.

Conclusion

Non-epileptic seizures aren’t caused by neurological issues, but they still greatly affect people’s lives, making It crucial to recognize the symptoms and understand the triggers for better management.

With the right psychological support and stress management, those with this type of seizure can live healthier, more stable lives. If you or someone you know shows symptoms of non-epileptic seizures, it’s essential to seek professional help for an accurate diagnosis and personalized treatment.