Epilepsy or Not? PNES Mistaken for More Common Seizure Disorder

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When someone collapses to the floor, back arching, arms and legs thrashing, your first thought may be epileptic seizure.

When someone collapses to the floor, back arching, arms and legs thrashing, your first thought may be epileptic seizure.

And you wouldn’t be alone—until recently, most doctors thought the same thing. During an epileptic seizure, the brain, which normally operates in an orderly way by sending electrical messages from neuron to neuron, becomes overloaded. If a healthy brain functions like a well-conducted orchestra, with each instrument playing its part at the right time, a brain during an epileptic seizure functions more like a chaotic musical mishmash, where every instrument plays at once, without regard for any of the others around it. Seizures caused by  epilepsy  overwhelm the brain with electronic messages, which is what causes the person to move uncontrollably or to see, hear, and feel things they normally wouldn’t.

But recent research suggests that about 10 percent of patients previously diagnosed with epilepsy don’t have epilepsy at all. These patients are actually having a different kind of seizure known as a “psychogenic non-epileptic seizure” or PNES. These seizures can look and feel the same as epileptic seizures, but people with PNES are not experiencing the same electrical overload in their brains. For this reason, traditional epilepsy treatments, such as anti-seizure medications, don’t work and can even introduce harmful side effects for these patients. In extreme cases, patients with PNES, who have not been helped by medications, have undergone unnecessary surgery in an attempt at a cure. But the problem is, seizures are not caused by an abnormality in the brain (the way they are with epilepsy).

Read more at Yale Medicine