Functional Neurological Disorders (FND)

Understanding psychogenic non-epileptic seizures

Psychogenic non-epileptic seizures (PNES) or episodes, also called dissociative seizures, or psychological non-epileptic seizures, look similar to epileptic seizures, but are not caused by abnormal electrical activity in the brain, and therefore show no electro-physiological correlation. PNES are often triggered by and exacerbated by psychological (emotional or stress-related) factors.

Psychogenic non-epileptic seizures have a similar appearance to epileptic seizures and can also cause auras, loss of consciousness, collapsing to the floor, uncontrollable shaking, difficulty breathing, clenching, paralysis, inability to speak, or stiffening of the body. Individuals experiencing a psychogenic non-epileptic seizure are often semi-conscious and clients have described that they can hear what is being said, but that they cannot speak, feel foggy, out-of-their-body, numb, or overtaken by a strong energy.

The prevalence of psychogenic non-epileptic seizures is somewhere between 2 and 33 per 100,000 (Benbadis and Hauser, 2000).

How is PNES diagnosed?

The most effective way of diagnosing PNES is video-EEG. Visual observation, history taking, and routine office EEG can give false positives. Due to their similarities, PNES is at times misdiagnosed as epilepsy, and it can take years for the patient to find out that he or she does not actually have epilepsy. PNES has been diagnosed in children, teenagers, and adults.

The Causes of PNES

Research suggests that accumulated stress and trauma in a person’s life can lead to the development of psychogenic non-epileptic seizures. Reports show that 70-90% of individuals with PNES have been exposed to accumulated stress and/or trauma during their life. Underlying conditions are in many cases depression (50-90% of individuals with PNES are also clinically depressed), post-traumatic stress disorder (25-58% of individuals are diagnosed with PTSD), and/or anxiety disorders (about 50% of individuals with PNES). In a sense, psychogenic non-epileptic seizures can be seen as a physical manifestation of psychological distress.

PNES are not consciously produced, and anywhere between 4 and 50% of individuals diagnosed with epilepsy also experience psychogenic non-epileptic seizures.

At the Rocky Mountain Center for Epilepsy we have seen a correlation not only between PTSD and PNES, but also between being “highly sensitive” and PNES. A highly sensitive person is an individual who has a sensory processing sensitivity, including hypersensitivity to external stimuli, a greater depth of cognitive processing, and high emotional reactivity.

Treatments for PNES

If you have been diagnosed with PNES you might feel confused. What does this diagnosis mean? Where do you go from here? How can you have seizures but not be diagnosed with epilepsy?

With PNES, your doctor might prescribe medication to manage accompanying psychological conditions such as depression or anxiety, but hopefully will also recommend psychotherapy. Psychotherapy can be useful to help a patient explore, understand and manage the stressors that lead to psychogenic non-epileptic seizures. Identifying triggers, reducing stressors while learning about effective stress coping strategies, working with anger and the often lack of assertiveness, while treating symptoms of PTSD can all be helpful tools on the journey of reducing or possibly eliminating psychogenic non-epileptic seizures.

Here at the Rocky Mountain Center for Epilepsy we specialize in offering holistic support for the underlying conditions of psychogenic non-epileptic seizures.

“I believe that no one needs to be alone (confused, isolated, hopeless) in this frightening experience and everyone has the ability to walk through and away from the reality of having functional neurological symptoms when educated and equipped with proper tools.” Afra Moenter, PhD

If you or someone you know has been diagnosed with FND, contact us to see how we can support your path to healing.

Are you ready to take the first step toward a seizure free life?

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