Psychogenic seizures are caused by intense stress or emotional upset, not abnormal electrical discharges. They can be difficult to distinguish from epileptic seizures, but EEG tests can help. Misdiagnosis can be harmful, and treatment involves psychotherapy and addressing the psychological origins of seizures.
Psychogenic seizures are episodes characterized by seizures and loss of motor control that are not caused by unusual electrical activity in the brain. Instead, such episodes are caused by intense stress or emotional upset and do not have a well-understood physical origin. Seizures, on the other hand, are caused by abnormal electrical discharges, so similar symptoms with psychogenic origins are commonly referred to as psychogenic non-epileptic seizures. Psychogenic seizures are sometimes called “pseudoseizures,” although this name is not widely used, because the lack of an understood physical mechanism for seizure symptoms resulting from stress and emotion does not make seizure episodes any less real.
Epileptic and psychogenic seizures look very similar, so it can sometimes be difficult to tell the two apart. There are some differences between epileptic and non-epileptic seizures, such as triggers and particular movements, but these are by no means conclusive. The most conclusive diagnostic test for psychogenic seizures involves the relatively long-term use of electroencephalography, or EEG, sometimes accompanied by video surveillance. EEG tests monitor electrical activity in the brain and can be used to determine if abnormal electrical discharges accompany a seizure, indicating epilepsy. These tests are sometimes done for days or weeks with accompanying video in order to collect and correlate observed seizure behavior with electrical EEG data.
It should be noted that while psychogenic seizures have psychological rather than physical origins, they are by no means “false” seizures. There are cases where individuals fake seizures for psychological reasons, for personal gain, or to avoid loss or punishment. In these cases, individuals who feign an attack are in complete control of their simulated symptoms. People who experience psychogenic seizures, on the other hand, lack control over their symptoms. Their seizures are involuntary in nature and are not calculated acts intended for personal gain.
Misdiagnosis of psychogenic seizures can be costly and harmful to patients. Psychogenic seizures that are misdiagnosed as seizures can be treated with anticonvulsant medications or even surgery. Both options are quite expensive and both can have unpleasant side effects. Misdiagnosis is, however, relatively rare given the ability of medical professionals to detect abnormal brain activity.
Most treatments for psychological crises are based on psychotherapy. Seizures can be reduced or prevented by discovering and addressing the precise psychological origins of seizures. In some cases, other psychological illnesses, such as depression, may be closely related to the seizures; medications such as antidepressants are often used in these cases.
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