Psychogenic Non-epileptic Seizures

Psychogenic non-epileptic seizures are common. These seizures are not due to epileptiform discharges in the brain and EEG recording during the seizure episodes are normal. On careful history taking, an underlying stress or psychiatric diagnosis can be found in most of these cases. These are also referred to as pseudo-seizures, hysterical seizures or dissociative (conversion) seizures.

Typical clinical features of psychogenic non-epileptic seizures include: 1. Seen in younger people, mostly in females, 2. Underlying psychological stress is present, 3. Repeated episodes of seizures occur, 4. Seizure duration is prolonged, 5. Patient may look fairly normal in between episodes, despite having multiple seizure episodes, 6. Pelvic thrusting movements, opisthotonus movements, etc are more common, 7. Eyes are usually closed during episodes, 8. Attacks are more frequent when in front of others, 9. Urinary incontinence is rare, 10. Tongue bite is rare, and if tongue is bitten, it is the tip (and not the sides as seen in true seizures), 11. Risk of injury during seizures is rare.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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