How to recognize a psychogenic non-epileptic seizure

A psychogenic non-epileptic seizure (PNES) is also known as a functional seizure. Psychogenic non-epileptic seizure (PNES) presentation can be concerning to parents as their child’s presentation can  resemble an epileptic disorder seizure. PNES can look and feel like an epileptic seizure for  patients, however they are not epileptic seizures. Epileptic seizures are caused by  abnormal electrical activity in the brain.  PNES does not show abnormal electrical activity and the electroenchaphalogram (EEG) test of the brain is typically normal, meaning there are no abnormal brain waves.

However, the symptoms a patient is experiencing are real and can be disruptful to daily life. A video EEG is the best test option to distinguish PNES from epileptic seizure
disorders.

Psychogenic non-epileptic seizures are often your body’s physical reaction to various types of stressors. Examples of these types of stressors can be trauma, injury,
pain, and psychological/ emotional distress.

Signs and symptoms of psychogenic non-epileptic seizures
  ● Pelvic thrusting
  ● Head shaking side to side
  ● Full body shaking that lasts 10 minutes or longer
  ● Abnormal body movements
  ● Repetitive motions
  ● Staring

In some cases, PNES can be triggered by trauma and stress in the pediatric population. It is important to keep this in mind and manage a child’s stress. Families can help patients work with coping  mechanisms to improve their symptoms. Examples of fun ways to relieve stress are exercise, walking outside, coloring, drawing, journaling, and reading. Trying out these activities and seeing what works best for your child can help decrease the frequency of these events if their stress levels are controlled. Cognitive
behavioral therapy has been  shown to improve symptoms in patients experiencing PNES and is an option if other ways to manage stress are not helping the patient. When
treating PNES, it is vital to have a multidisciplinary team of healthcare professionals including a neurologist, psychiatrist, and psychologist. Combining all of these specialties together for treatment provides optimal results for the patient and creates a team who can help mitigate psychological distress for the patient.

Author: Kayleigh Pignato OMS-IV ATSU-KCOM