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Non-Epileptic Seizures Pediatric Epilepsy Non-Epileptic Seizures What are they? Organic non-epileptic seizures: have a physical cause Events that look like seizures but are not caused by epilepsy (relating to the body). Examples include fainting (syncope) or by other factors which could lead to seizures (such as and metabolic causes (a result of certain biochemical diabetes, tumors, strokes or electrolyte imbalance) are processes in the body) such as diabetes. Because they have called “non-epileptic seizures.” Non-epileptic seizures a physical cause, they may be relatively easy to diagnose (NES) are not caused by disrupted electrical activity in and the underlying cause can be found. the brain and are different from epilepsy. They can have a number of different causes. Non-epileptic seizures are Psychogenic non-epileptic seizures: The term a result of subconscious mental activity, not of abnormal “Psychogenic” means they are caused by mental or electrical activity in the brain. Doctors consider most of emotional processes, rather than by a physical cause. them to be psychological in nature, but not intentionally Psychogenic seizures may happen when someone’s reaction produced. Although not epilepsy, these events are very to painful or difficult thoughts and feelings affects them real and can be very distressing for the patient and the physically. They include different types: family. Usually the person is not aware that the spells are • Dissociative seizures happen unconsciously, which not “epileptic.” Common names include “psychogenic means that the person has no control over them and seizures” (si-ko-JEN-ik), which means beginning in the they are not “faking it.” This is the most common type mind and “pseudo-seizures.” of non-epileptic seizures. Are they common? • Panic attacks can happen in frightening situations, Non-epileptic seizures are common. About 20 percent of when remembering previous frightening experiences or the patients referred to comprehensive epilepsy centers in situations that the person expects to be frightening. for study with video-EEG are found to have non-epileptic Panic attacks can cause sweating, palpitations (being seizures. However, about 1 in 6 of these patients either able to feel your heart beat), trembling and difficulty also has epileptic seizures or has had them. These people breathing. The person may also lose consciousness need different treatment for each disorder. Psychogenic and may shake (convulse). non-epileptic seizures have been more widely recognized • Factitious seizures means that the person has some during the past several decades. They are most often seen level of conscious control over them. An example in adolescents and young adults, but they can also occur of this is when a person is driven by a need to in children and the elderly. They are three times more seek attention or have medical investigations common in females. and treatments. What do they look like? How are they recognized? These events most often imitate epileptic seizures, most Doctors have identified certain kinds of movements often the complex partial or the tonic-clonic (grand mal) and other patterns that seem to be more common in types. Family members report episodes in which the psychogenic non-epileptic seizures than in seizures caused patient has a blank stare with unresponsiveness or by epilepsy. Some of these patterns do occur occasionally stiffens and jerks. in epileptic seizures, so having one of them does not necessarily mean that the seizure was non-epileptic. Non-epileptic seizures (NES) can be divided into two types: organic and psychogenic. Continued on reverse side How are non-epileptic seizures diagnosed? Can they be treated? If you have seizures, your family doctor will usually refer you to Psychogenic non-epileptic seizures do not necessarily indicate a specialist for diagnosis. This will usually be a neurologist or that the person has a serious psychiatric disorder. The problem epileptologist to first see if the seizures are epileptic. It may be does need to be addressed and many patients need treatment. easier for doctors to try and rule out possible physical causes Sometimes the episodes stop when the person learns that they first, including epilepsy. This will influence the types of tests are psychological. Some people have depression or anxiety you might have. disorders that can be helped by medication. Counseling for a limited time is often helpful. The person needs to accept Medical tests the diagnosis (at least as a possibility) and follow through with therapy. Some tests are used to rule out other causes of seizures, including epilepsy. Treatment options • Medical examinations and blood tests can be used to Treatment may depend on the cause of your seizures and your check your overall health and see if your seizures have a medical history. Your specialist will talk to you about what physical cause such as diabetes. treatment options might be helpful. • Brain scans such as CT (Computerized Tomography) or Medication MRI (Magnetic Resonance Imaging) are used to form a Seizures that are not epileptic will not be controlled by picture of your brain. This may show a physical cause anti-epileptic drugs (AEDs). for epileptic seizures but would not usually be helpful in diagnosing NES. • If you already take anti-seizure medications, for example if you were previously mis-diagnosed with epilepsy, your • An EEG (electroencephalogram) records the electrical specialist may suggest you gradually reduce them. activity of the brain. It is often used to see if seizures are caused by disrupted brain activity, which helps to • If you have both epilepsy and NES, your doctor will help diagnose epilepsy. NES are not caused by changes in you and your family recognize the epileptic seizures from brain activity. the non-epileptic events and will continue to treat the epileptic seizures with anti-seizure medications. • Video-EEG involves having an EEG and being filmed at the same time. This compares what a person is doing with • If you also have anxiety or depression, your specialist what is happening in their brain during the event and can might talk to you about whether other medications, such often show the difference between epileptic and as anti-depressants, might be helpful. non-epileptic seizures. If the tests show no neurological or physical cause for your Other forms of treatment seizures, and your specialist thinks it might be NES you may • Psychotherapy is the most commonly recommended be referred to a psychiatrist or a psychologist for diagnosis. treatment for NES. Psychotherapy is the name for a form of therapy which involves counseling rather than medication. Mental health professionals, including psychiatrists and psychologists, are trained in different forms of psychotherapy. • Cognitive behavioral therapy (CBT) is often recommended for NES. It looks at how you think about things, how this affects you physically and emotionally and how it affects what you do (your behavior). By changing the way you think about yourself, other people and the world around you, this may change the way that you behave. CBT tends to focus on how things are affecting you in the The science of health. The art of compassion. present and ways to help you view current situations more positively and cope with stressful events. 216-800-4320 | UHRainbow.org To make an appointment with a pediatric epilepsy expert, call 216-800-4320 or visit UHRainbow.org. © 2021 University Hospitals.
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