Psychogenic non-epileptic seizures (PNES) are common in clinical practice. The diagnosis of PNES is commonly missed or delayed. The diagnosis of PNES should be suspected, if a person has repeated seizures despite being on good anti-epileptic drugs. Other features that help in accurate diagnosis of PNES are: 1. The semiology of non-epileptic seizure is unlike any other known seizure type, 2. Movements such as pelvic thrusting and opisthotonus are more common, 3. The person is usually alert and awake, immediately after a “generalized event”. which is unlikely after a true seizure. 4. The person with PNES tends to avoid injuries such as tongue bite or falls.
In this video, one can see the bizarre and asynchronous movements of various parts of body. The child is able to obey verbal commands immediately after the event. These features were suggestive of PNES. The diagnosis was confirmed by a video EEG, and the child was referred to a psychiatrist for further evaluation and management.