Psychogenic seizures

• Psychogenic non-epileptic seizures (PNES) are events resembling an epileptic seizure, but without the characteristic electrical discharges associated with epilepsy.
• PNES fall under the category of disorders known as functional neurological disorders (FND), also known as conversion disorders.
• A more recent term to describe these events is dissociative non-epileptic seizures.
• These are typically treated by psychologists or psychiatrists.
• PNES has previously been called pseudoseizures, psychogenic seizures, and hysterical seizures, but these terms have fallen out of favor.
• Prevalence is estimated 5–20% of outpatient epilepsy clinics; 75–80% of these diagnoses are given to female patients and 83% are to individuals between 15 and 35 years old.
• Individuals with PNES present with episodes that resemble epileptic seizures, and most have received a diagnosis of epilepsy and treatment for it. PNES episodes are nearly indistinguishable from epileptic seizures. The main differences between a PNES episode and an epileptic seizure is the duration of episodes. Epileptic seizures typically last between 30 and 120 seconds depending on the type, while PNES episodes typically last for two to five minutes.
• The cause of PNES has not yet been established. One hypothesis is that they are a learned physical reaction or habit the body develops, similar to a reflex. The individual does not have control of the learned reaction, but this can be retrained to allow the patient to control the physical movements again. The production of seizure-like symptoms is not under voluntary control, meaning that the person is not faking; symptoms which are feigned or faked voluntarily would fall under the categories of factitious disorder or malingering.

Risk factors for PNES include having a history of head injury, and having a diagnosis of epilepsy. Approximately 10–30% of people diagnosed with PNES also have an epilepsy diagnosis. People diagnosed with PNES commonly report physical, sexual, or emotional trauma, but the reported incidence of these events may not differ between PNES and epilepsy.