Psychogenic Non-Epileptic Seizures (PNES)

(an older term, pseudo-seizures, is no longer used)

Psychogenic seizures are not due to epilepsy. Psychogenic seizures can occur at any age, but are more common in people under the age of 55. They occur three times more frequently in women than men. They may arise from various psychological factors, may be prompted by stress, and may occur in response to suggestion.

Some individuals with psychogenic non-epileptic seizures may have previously experienced trauma, such as sexual abuse.

Psychogenic seizures can be characterized by features common with epilepsy seizures. It may be difficult to differentiate between psychogenic non-epileptic seizures and epilepsy seizures. The gold-standard for diagnosis is to record the seizures during an admission to an epilepsy monitoring unit. A neurologist can anlayse the video and EEG recordings to determine if the seizures are due to epilepsy or PNES.

An accurate diagnosis is important in order to receive the appropriate treatment.

Psychogenic seizures are not caused by electrical discharges in the brain and thus the EEG abnormalities seen during an epilepsy seizure are absent, however PNES can be mistaken for epilepsy. It is also possible to have both psychogenic seizures and epilepsy.

Antiseizure medications are ineffective in the treatment of psychogenic disorders. Patients who are diagnosed with psychogenic seizures are usually referred to a psychiatrist or therapist, to learn to manage stress and become familiar with coping techniques. Behavioural modification therapy can be an effective treatment for PNES.