Psychogenic Nonepileptic Seizures

A seizure is a temporary loss of bodily control, often appearing as convulsions or the loss of consciousness. Many people suffer seizures because of the brain disorder known as epilepsy, where the cause in an interruption of neural activity in the brain. However, there are also a number of people who experience seizures unrelated to epilepsy. A nonepileptic seizure, also known as a “pseudoseizure,” is more common than many people realize, and they are often the result of underlying psychological conditions.

About Pseudoseizure Disorders

Despite the name, a psychogenic nonepileptic seizure (PNES), often referred to as a pseudoseizure, is in fact an actual seizure. Pseudoseizures share many of the same characteristics as epileptic seizures. These include convulsions, jerking motions, falling or collapsing, stiffening of the body, dissociation, and losing consciousness. What differentiates PNES from other seizure disorders is that the seizures are not caused by a physiological condition involving neural disruption. Instead, pseudoseizures are typically the physical manifestation of psychological distress.

Many people who experience pseudoseizures also suffer from one or more underlying mental health disorders. These seizures, while real, are often the somatic expression of unresolved trauma or mental illness. Conditions that can cause nonepileptic seizures include:

• Repressed physical or sexual abuse
• Post-traumatic stress disorder (PTSD)
• Severe panic or anxiety disorders
• Anger management issues
• Dissociative disorders
• Disorders with psychotic features, such as schizophrenia
• Personality disorders, such as BPD
• Substance abuse

How To Treat Nonepileptic Seizures

An effective treatment plans for pseudoseizures must address the underlying mental health disorder that is causing them. Because they resemble epileptic seizures, pseudoseizures are often mistakenly identified as a neurological problem, rather than a psychological condition. Once epilepsy has been ruled out, individuals with PNES should undergo a complete psychiatric evaluation by a psychiatrist experienced with treating somatization disorders.

Once the underlying condition has been determined, be it trauma, anxiety, or substance abuse, a treatment plan can be developed that addresses the condition without exacerbating the seizure symptoms. Some of the more effective therapies for PNES (depending on the diagnosis) include:

• Psychopharmacology & medication management
• Behavioral therapy, such as CBT or DBT
• Relaxation therapy (Yoga, meditation, etc)
• Eye movement desensitization & reprocessing (EMDR)
• Family therapy

If nonepileptic seizures are the result of trauma, therapies that expose and resolve repressed memories, such as EMDR, have shown to be effective in eliminating seizures by reducing emotional distress. Other therapies, like dialectical behavior therapy (DBT), help pseudoseizure sufferers learn emotional self-regulation, so that internal anguish does not manifest in the form of seizures. Combined with relaxation techniques and a proper regimen of psychotropic medication, individuals whose lives have been severely impaired by PNES have been able to regain a healthy quality of life.