Non-Epileptic Seizures
Overview
Epileptic seizures are caused by unusual electrical activity in the brain. Seizures may briefly affect:
- Muscle control
- Movement
- Speech
- Vision
- Awareness
Some people experience symptoms similar to those of an epileptic seizure but without any unusual electrical activity in the brain. When this happens it is known as a non-epileptic seizure (NES).
NES is most often caused by mental stress or a physical condition. Different types of NES include:
- Fainting
- Panic attacks
- Dissociative seizures (uncontrollable)
Symptoms
NES symptoms are most often similar to those of a generalized epileptic seizure. This may include:
- Convulsions
- Crying out or making a noise
- Stiffening
- Jerky, rhythmic or twitching motions
- Falling down
- Loss of consciousness
- Confusion after returning to consciousness
- Loss of bladder control
- Biting the tongue
NES can also be similar to partial seizures. These symptoms may include:
- Jerky or rhythmic movements
- Sensations such as tingling, dizziness, feeling full in the stomach
- Repetitive motions
- Staring
- Confusion
- Changes in emotions
- Altered senses
Causes and Risk Factors
NES is most often caused by mental stress or a physical condition, including:
- A heart condition that causes fainting
- Diabetes or other metabolic disorders
- Emotional pain
- Mental pain
- Being bullied
- Physical or sexual abuse
- A major accident
NES is most common in women.
NES is more common in people with other conditions such as depression or anxiety.
Diagnosis
When seizures are present, the doctor will often test the patient for epilepsy. The most useful test in confirming epilepsy is an electroencephalogram (EEG). This records electrical activity in the brain including abnormal spikes in electrical activity patterns. Different types of epilepsy can be identified with these patterns.
A patient with NES will not show unusual electrical activity in the brain on the EEG.
Magnetic resonance imaging (MRI) and computed tomography (CT) scans may be used to look for epilepsy as well. However, these tests are not very helpful for NES.
Blood tests may be used to look for underlying conditions such as diabetes.
If the doctor suspects NES the patient will be referred to a psychologist for further diagnosis and treatment.
Treatment
Psychotherapy is the most common treatment for NES. This may include cognitive behavioral therapy (CBT). CBT examines the connection between a person's thoughts and their feelings and behaviors. CBT and other psychotherapies take several months to work. It is important that the patient continue their treatment plan during this time.
NES does not respond to anti-seizure medications. However, medications for depression or anxiety may be used as part of the treatment plan.
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