While most seizures are caused by epilepsy, some people experience seizures that are classified as non-epileptic seizures. In fact, about 25% of seizure patients referred to specialists for cases of “drug-resistant epilepsy” are found to be mis-diagnosed cases of non-epileptic seizures. These seizures may look similar or be just as distressing as an epileptic seizure, but what causes them, how they affect the body and how they are treated are different. Here, Asad Yousuf, M.D., a neurologist at Henry Ford Health, explains how non-epileptic seizures work.
Q: What causes non-epileptic seizures?
Dr. Yousuf: We don’t fully understand the complete biological causes of non-epileptic seizures yet. Most non-epileptic seizures fall under the classification known as psychogenic non-epileptic seizures (PNES). These seizures are episodes of abnormal movements that mimic epileptic seizures – often as the result of an underlying psychological conflict associated with anxiety, depression, personality disorders or traumatic life experiences. These episodes are complex and likely due to an impairment between how the mind, brain and body communicate with each other.
We also know that there is a subset of patients who experience seizure-like events that are non-epileptic caused by movement disorders or heart arrhythmia.
Q: How do doctors tell the difference between an epileptic or non-epileptic seizure?
Dr. Yousuf: One of the biggest differences between epileptic and non-epileptic seizures is that non-epileptic seizures don’t cause the same electrical disturbances in the brain that epileptic seizures do. In most cases, we can’t tell the difference between the two until the seizure is observed by an epilepsy specialist in an epilepsy monitoring center. Using a test called an electroencephalogram (EEG), specialists can monitor electrical activity in the brain. Epileptic seizures create changes in the brain whereas non-epileptic seizures do not.
Q: What does treatment for non-epileptic seizures look like?
Epilepsy Care At Henry Ford
Dr. Yousuf: Sometimes, patients may see improvement in their symptoms once the distinction between epileptic versus non-epileptic seizures is made. This is because getting an actual diagnosis can relieve some stress surrounding your health. In any case, seeing a specialist about your seizures early is your best bet.
Unfortunately, there are not medications or treatments we can use to make non-epileptic seizures go away. Because these seizures don’t cause electrical disturbances, the anticonvulsant medications used to treat epilepsy won’t have any effects. Cognitive behavioral therapy is our best recommendation to help in retraining your body’s behavioral responses. This can take some time because patients must be open to the process of learning about this condition and working with a therapist to manage their triggers and symptoms. Additionally, taking prescribed medication to help you manage anxiety, depression or other mental health disorders has been shown to decrease frequency of seizures.
Your neurologist may want to see you for follow-up appointments over time to monitor any changes in your seizures. However, once your seizures have been confirmed to be non-epileptic, it is likely you will meet only with a mental health professional for therapy.
Q: What should you do if you or someone you know has a seizure?
Dr. Yousuf: If you or someone you know experiences a seizure for the first time, you need to go to the emergency room. While not all seizures may be cause for concern, it is important that you are evaluated by a specialist to determine the cause. From there, your doctor can provide more information about treatment or when you should seek care for any future seizures based on your diagnosis.
Reviewed by Dr. Asad Yousuf, a neurologist who sees patients at Henry Ford West Bloomfield Hospital Clinics.
