What are Non Epileptic Seizures

A seizure can cause:

• Involuntary movements, like falling or shaking.
• Changes in awareness or consciousness.
• Convulsions. These are episodes of uncontrollable, jerking movement caused by sudden, intense tightening (contraction) of the muscles.

Epileptic seizures are caused by abnormal electrical activity in the brain. Non-epileptic seizures are different. They are not caused by abnormal electrical signals in your brain. These seizures may look like epileptic seizures, but they are not caused by epilepsy.

There are two types of non-epileptic seizures:

• Physiologic non-epileptic seizure. This type results from an underlying problem that causes a disruption in your brain’s electrical activity.
• Psychogenic non-epileptic seizure. This type results from emotional stress. These seizures are sometimes called pseudoseizures.

What are the causes?

Causes of physiologic non-epileptic seizures can include:

• Sudden drop in blood pressure.
• Low blood sugar (glucose).
• Low levels of salt (sodium) in your blood.
• Low levels of calcium in your blood.
• Migraine.
• Heart rhythm problems.
• Sleep disorders, such as narcolepsy.
• Movement disorders, such as Tourette syndrome.
• Infection.
• Certain medicines.
• Drug and alcohol abuse.
• Fever.

Common causes of psychogenic non-epileptic seizures can include:

• Stress.
• Emotional trauma.
• Sexual or physical abuse.
• Major life events, such as divorce or death of a loved one.
• Mental health disorders, including anxiety and depression.

What are the signs or symptoms?

Symptoms of a non-epileptic seizure can be similar to those of an epileptic seizure, which may include:

• A change in attention or behavior (altered mental status).
• Loss of consciousness or fainting.
• Convulsions with rhythmic jerking movements.
• Drooling.
• Rapid eye movements.
• Grunting.
• Loss of bladder control and bowel control.
• Bitter taste in the mouth.
• Tongue biting.

Some people experience unusual sensations (aura) before having a seizure. These can include:

• “Butterflies” in the stomach.
• Abnormal smells or tastes.
• A feeling of having had a new experience before (déjà vu).

After a non-epileptic seizure, you may have a headache or sore muscles or feel confused and sleepy. Non-epileptic seizures usually:

• Do not cause physical injuries.
• Start slowly.
• Include crying or shrieking.
• Last longer than 2 minutes.
• Include pelvic thrusting.

How is this diagnosed?

Non-epileptic seizures may be diagnosed by:

• Your medical history.
• A physical exam.
• Your symptoms.
  • Your health care provider may want to talk with your friends or relatives who have seen you have a seizure.
  • If possible, it is helpful if you write down your seizure activity, including what led up to the seizure, and share that information with your health care provider.

You may also need to have tests to look for causes of physiologic non-epileptic seizures. These may include:

• An electroencephalogram (EEG). This test measures electrical activity in your brain. If you have had a non-epileptic seizure, the results of your EEG will likely be normal.
• Video EEG. This test takes place in the hospital over the course of 2–7 days. The test uses a video camera and an EEG to monitor your symptoms and the electrical activity in your brain.
• Blood tests.
• Lumbar puncture. This test involves pulling fluid from your spine to check for infection.
• Electrocardiogram (ECG or EKG). This test checks for an abnormal heart rhythm.
• CT scan.

If your health care provider thinks you have had a psychogenic non-epileptic seizure, you may need to see a mental health specialist for an evaluation.

How is this treated?

The treatment for your seizures will depend on what is causing them. When the underlying condition is treated, your seizures should stop.

If your seizures are being caused by emotional trauma or stress, your health care provider may recommend that you see a mental health professional. Treatment may include:

• Relaxation therapy or cognitive behavioral therapy.
• Medicines to treat depression or anxiety.
• Individual or family counseling.

In some cases, you may have psychogenic seizures in addition to epileptic seizures. If this is the case, you may be prescribed medicine to help with the epileptic seizures.

Follow these instructions at home:

Home care will depend on the type of non-epileptic seizures that you have. In general:

• Follow all instructions from your health care provider. These may include ways to prevent seizures and what to do if you have a seizure.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.
• Make sure family members, friends, and coworkers are trained on how to help you if you have a seizure. If you have a seizure, they should:
  • Lay you on the ground to prevent a fall.
  • Place a pillow or piece of clothing under your head.
  • Loosen any clothing around your neck.
  • Turn you onto your side. If vomiting occurs, this helps keep your airway clear.
• Avoid any substances that may prevent your medicine from working properly. If you are prescribed medicine for seizures:
  • Do not use recreational drugs.
  • Limit or avoid alcoholic beverages.

Contact a health care provider if:

• Your seizures change or become more frequent.
• You continue to have seizures after treatment.

Get help right away if:

• You injure yourself during a seizure.
• You have one seizure after another.
• You have trouble recovering from a seizure.
• You have chest pain or trouble breathing.
• You have a seizure that lasts longer than 5 minutes.

Summary

• Non-epileptic seizures may look like epileptic seizures, but they are not caused by epilepsy.
• The treatment for your seizures will depend on what is causing them. When the underlying condition is treated, your seizures should stop.
• Make sure family members, friends, and coworkers are trained on how to help you if you have a seizure. If you have a seizure, they should lay you on the ground to prevent a fall, protect your head and neck, and turn you onto your side.