Learning About Psychogenic Non-Epileptic Seizure

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What is psychogenic non-epileptic seizure (PNES)?

Psychogenic non-epileptic seizures (PNES) don't have a physical cause. They aren't caused by epilepsy. But people with epilepsy also may have PNES. People who have a lot of stress, mental illness, or emotional trauma may be more likely to have PNES.

Even though PNES doesn't have a physical cause, it is a real condition. The seizures can be scary. And not knowing why you're having them can be frustrating.

What happens during PNES?

PNES may look like epileptic seizures. But epileptic seizures usually follow the same pattern every time. With PNES, each episode may be different.

During a PNES episode, you may have jerky movements, tingling skin, or problems with coordination. You may notice changes in your vision or sense of smell.

Some people have episodes often. Others have them only once in a while. For some people, episodes stop over time. Other people keep having them.

How is PNES diagnosed?

Your doctor will do tests to find out if you have epilepsy. An EEG test lets your doctor see the electrical activity of your brain. The test is often used to diagnose epilepsy. It helps your doctor know what types of seizures you are having.

Your doctor also may do blood tests.

PNES can be mistaken for epilepsy at first. As a result, some people with PNES are treated with epilepsy medicines. But most of the time, these medicines don't help. The right diagnosis allows your doctor to give you treatments that will help with the stress and other issues that may be related to PNES.

How is PNES treated?

Treatment varies with each person. The goals of treatment are to relieve stress and to help you learn ways to cope with difficult areas of your life. You may get medicines or counselling.

A type of counselling called cognitive-behavioural therapy (CBT) may help with the stress and emotional issues. In CBT, you learn to identify and change thinking styles that may be adding to your stress. CBT is done by licensed mental health providers, such as psychologists, social workers, and therapists. It can be done in one-on-one sessions or in a group setting.

Care at home

Lowering your stress may help with PNES. Here are some things you can do.

How to relax your mind

  • Write. It may help to write about things that are bothering you. This helps you find out how much stress you feel and what is causing it. When you know this, you can find better ways to cope.
  • Let your feelings out. Talk, laugh, cry, and express anger when you need to. Talking with friends, family, a counsellor, or a member of the clergy about your feelings is a healthy way to relieve stress.
  • Do something you enjoy. For example, listen to music or go to a movie. Practice your hobby or do volunteer work.
  • Meditate. This can help you relax, because you are not worrying about what happened before or what may happen in the future.
  • Do guided imagery. Imagine yourself in any setting that helps you feel calm. You can use audiotapes, books, or a teacher to guide you.

How to relax your body

  • Do something active. Exercise or activity can help reduce stress. Walking is a great way to get started. Even everyday activities such as housecleaning or yard work can help.
  • Do breathing exercises. For example:
    1. From a standing position, bend forward from the waist with your knees slightly bent. Let your arms dangle close to the floor.
    2. Breathe in slowly and deeply as you return to a standing position. Roll up slowly, and lift your head last.
    3. Hold your breath for just a few seconds in the standing position.
    4. Breathe out slowly and bend forward from the waist.
  • Try yoga or tai chi. These techniques combine exercise and meditation. You may need some training at first to learn them.

Talk to your doctor about whether it is safe to do certain activities, such as drive or swim.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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