Non-epileptic seizures resemble epileptic seizures but have different underlying causes, including psychological factors. Misdiagnosis is common, and video EEG monitoring can help distinguish between the two. Treatment for psychogenic seizures often involves psychotherapy.
A non-epileptic seizure is a type of seizure that, while it may look the same to an onlooker as an epileptic seizure, has a different underlying cause. Both types of seizures can occur while asleep or while awake and can cause a person to lose consciousness, tremble, perform strange movements repeatedly, or lose bladder control. Typically, an epileptic seizure is triggered by abnormal electrical impulses in the brain, but this is not the case for a non-epileptic seizure. In fact, there are several causes of non-epileptic seizures, including fainting, hypoglycemia, heart problems, and psychological factors.
Because the signs of a nonepileptic seizure resemble those of a seizure, it can be difficult to distinguish between the two. About a quarter of epilepsy cases where drug treatment doesn’t work are later found to have been misdiagnosed. Many of these cases are actually non-epileptic seizures, often with psychological causes. When a non-epileptic seizure has a psychological cause it is described as psychogenic. A non-epileptic seizure with a physical cause is classified as organic.
Some psychogenic non-epileptic seizures are known as dissociative seizures. These are probably the most common form of non-epileptic seizures, and are triggered by memories of past traumatic experiences that resurface, sometimes during times of stress or just casually. The emotions turn into physical effects and the person has an attack over which they have no control. Sometimes the crises start right after the original shocking event and other times they start years later. It is not always possible to find out what the original event may have been.
Diagnosing a nonepileptic seizure can be made using video EEG monitoring, in which an electroencephalogram, or EEG, records the brain’s electrical activity as the patient is filmed. If no abnormal electrical events are measured while the patient is having a seizure, this helps confirm that the seizure is not epileptic. The technique can be useful for studying movement and behavior during seizures, as there may be subtle signs that tell an expert that the condition is not epilepsy.
Treatment for non-epileptic seizures varies and, in the case of organic seizures, will depend on the physical problem. In the case of a nonepileptic psychogenic seizure, treatment usually involves psychotherapy rather than medication. Methods such as cognitive behavioral therapy or CBT, which changes the way a person thinks, can be effective.
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