What are Non Epileptic Seizures in Children

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 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 the 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 the blood.
• Low levels of calcium in the blood.
• Migraine.
• Heart rhythm disorders.
• Sleep disorders, such as narcolepsy.
• Movement disorders, such as Tourette syndrome.
• Infection.
• Certain medicines.
• Fever.

Common causes of psychogenic non-epileptic seizures include:

• Stress.
• Emotional trauma.
• Sexual or physical abuse.
• Major life events, such as divorce or the 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 children 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, your child 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 child’s medical history.
• A physical exam.
• Your child’s symptoms. Your child’s health care provider will want to talk with you and may want to talk with friends or relatives who have seen your child have a seizure. It is helpful if you write down your child’s seizure activity, including what led up to the seizure, and share that information with your child’s health care provider.

Your child 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 child’s brain. If your child has had a non-epileptic seizure, the results of the 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 child’s symptoms and the electrical activity in your child’s brain.
• Blood tests.
• Lumbar puncture. This test involves pulling fluid from the spine to check for infection.
• Electrocardiogram (ECG or EKG). This test checks for an abnormal heart rhythm.
• CT scan.

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

How is this treated?

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

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

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

In some cases, your child may have psychogenic seizures in addition to epileptic seizures. If this is the case, your child 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 your child has. In general:

• Follow all instructions from your child’s health care provider. These may include ways to prevent seizures and how to care for your child if he or she has a seizure.
• Give your child over-the-counter and prescription medicines only as told by your child’s health care provider.
• Keep all follow-up visits as told by your child’s health care provider. This is important.
• Make sure family members, caregivers, and teachers are trained on how to help your child if he or she has a seizure.
• If your child starts to have a seizure:
  • Keep your child safe from injury. Move him or her away from any dangers.
  • Do not try to restrain your child’s movement.
  • Do not put anything in your child’s mouth.
  • Speak calmly to your child during the seizure.
  • Do not call emergency services unless your child is injured or the attack goes on for a long time.

Contact a health care provider if:

• Your child’s seizures change or become more frequent.
• Your child continues to have seizures after treatment.

Get help right away if:

• Your child is injured during a seizure.
• Your child has one seizure after another.
• Your child is having trouble recovering from a seizure.
• Your child has trouble breathing or chest pain.
• Your child has 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 child’s seizures will depend on what is causing them. When the underlying condition is treated, your child’s seizures should stop.
• If your child starts to have a seizure, you should prevent him or her from falling, protect your child’s head and neck, and turn your child onto his or her side.