Psychogenic non-epileptic seizure
| Psychogenic non-epileptic seizure | |
|---|---|
| Other names | Functional seizures, dissociative seizures, non-epileptic attack disorder (NEAD), non-epileptic seizures (NES), functional non-epileptic attacks (FNEA) |
| Specialty | Neurology, psychiatry |
| Symptoms | Seizure-like episodes without EEG evidence of epilepsy; may include unresponsiveness, shaking, or altered awareness |
| Complications | Misdiagnosis as epilepsy, impaired quality of life |
| Duration | Variable; can persist without treatment |
| Diagnostic method | Clinical evaluation, video-EEG monitoring |
| Differential diagnosis | Epileptic seizures, syncope, panic attacks, movement disorders, migraine, hypoglycemia |
| Treatment | Patient education, psychotherapy (especially cognitive behavioral therapy), treatment of comorbid conditions |
Psychogenic non-epileptic seizures (PNES), also referred to as functional seizures or dissociative seizures, are episodes that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, they are classified as a type of functional neurological disorder (FND), in which symptoms arise from changes in brain function rather than structural disease or epilepsy. During a PNES episode, seizure-like behavior occurs in the absence of epileptiform activity on electroencephalogram (EEG).
PNES can be difficult to distinguish from epileptic seizures based on clinical observation alone. Diagnosis is typically confirmed through video-EEG monitoring, which records both the clinical event and the absence of epileptiform activity. These episodes are involuntary and genuine, not consciously produced. Management primarily involves psychological treatment, particularly cognitive behavioral therapy (CBT). Outcomes vary and are influenced by factors such as early diagnosis, therapeutic engagement, and coexisting psychiatric conditions.