Non-epileptic seizure

Non-epileptic seizures (NES) are paroxysmal events that resemble epileptic seizures but are not caused by abnormal electrical discharges in the brain. They are not a single condition, but a descriptive category encompassing multiple disorders that can produce seizure-like episodes without the electrical activity that defines epilepsy. Some arise from functional disruptions in brain activity, as seen in psychogenic non-epileptic seizures (PNES) – a common subtype classified under functional neurological disorders. Others result from physiological causes, including fainting, sleep disorders, or movement disorders, which can mimic epileptic seizures despite distinct mechanisms.

Non-epileptic seizures do not respond to anti-seizure medications. The gold standard for distinguishing them from epilepsy is video-electroencephalographic (video-EEG) monitoring. Management depends on the underlying cause: functional seizures are treated with psychological and rehabilitative therapies, while physiological mimics require targeted medical care.