What Are Psychogenic Nonepileptic Seizures (PNES)?

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Psychogenic nonepileptic seizures (PNES) are a condition in which someone experiences physical symptoms associated with epileptic seizures, but the cause of these symptoms has no physiological basis.

Instead, they are caused by psychological factors such as stress, trauma, or mental health problems. Common symptoms of PNES include convulsions and other movement disorders, changes in consciousness or awareness, strange bodily sensations, and emotional outbursts.

PNES is often misdiagnosed as epilepsy due to its similarity in physical characteristics. However, it is important to note that PNES does not involve abnormal electrical activity in the brain like an epileptic seizure; instead, its cause lies within psychological issues.

It is important for individuals experiencing PNES to receive an accurate diagnosis and proper treatment, which may involve psychotherapy, medication, lifestyle changes, or a combination of these treatments.

Other names for PNES include psychogenic seizures, pseudoseizures, functional seizures, and non-epileptic events. Although PNES can cause physical symptoms similar to epileptic seizures, it is not a form of epilepsy or a result of neurological damage. Conditions associated with PNES may include anxiety, depression, posttraumatic stress disorder, or dissociative disorders.

Symptoms of Psychogenic Nonepileptic Seizures (PNES)

Below is a list of some common symptoms associated with PNES:

  • Convulsions or body tremors
  • Changes in consciousness, such as confusion and lack of awareness
  • Unusual sensations throughout the body, such as numbness, tingling, or burning
  • Emotional outbursts including crying, laughing, or shouting
  • Loss of control over physical movements
  • Difficulty speaking or understanding speech
  • Loss of bladder control or difficulty controlling bowel movements
  • Memory loss during a seizure episode
  • Headache after the event has ended

If you experience any of these symptoms regularly, it is important to seek medical attention from your doctor to obtain an accurate diagnosis and proper treatment.

Diagnosis of Psychogenic Nonepileptic Seizures (PNES)

Due to the similarity in physical characteristics of PNES and epileptic seizures, it can be difficult to diagnose. To accurately diagnose PNES, doctors must rule out other possible causes of the symptoms. This may include performing a physical examination, taking a medical history, or ordering an EEG or brain scan to observe electrical activity in the brain.

It is important for individuals living with PNES to receive an accurate diagnosis and proper treatment plan to manage their condition effectively.

Causes of Psychogenic Nonepileptic Seizures (PNES)

The cause of PNES is not as yet fully understood, but recent research suggests that it can be attributed to psychological and emotional stressors such as trauma, depression, or anxiety.

Below is a list of some possible underlying causes:

  • Trauma or a history of abuse
  • Anxiety or depression
  • Posttraumatic stress disorder (PTSD)
  • Dissociative disorders (disorders that affect your sense of self and disconnect from reality)

Treatment for Psychogenic Nonepileptic Seizures (PNES)

Treatment for PNES typically involves a combination of therapy, medication, and lifestyle changes. Depending on the severity of your condition, your doctor may recommend one or more of the following treatments:

  • Psychotherapy: This type of therapy aims to address underlying psychological issues that may be contributing to seizures. It can also provide a supportive environment to help individuals cope with the challenges associated with living with PNES.
  • Anti-anxiety medications: These medications can help reduce stress and anxiety levels, potentially triggering more seizures.
  • Cognitive-behavioral therapy (CBT): This therapy helps individuals learn coping strategies to manage their emotions and behaviors, which can help reduce the frequency and intensity of seizures.

Coping With Psychogenic Nonepileptic Seizures (PNES)

Living with PNES can be a challenging experience, and it is important to develop strategies for managing symptoms and reducing the frequency of seizures.

Here are a few tips to help you cope with your condition:

  • Make sure you get enough rest each night so that your body has time to recover from the seizure
  • Exercise regularly as this can help reduce stress levels and improve overall well-being
  • Eat healthy meals and snacks throughout the day, avoiding processed foods and sugary drinks that could potentially trigger more seizures
  • Connect with support groups or individuals who have similar experiences so that you don't feel alone
  • Practice relaxation techniques such as deep breathing or yoga to help ease stress and anxiety
  • Talk to your doctor about possible medications or treatments that could help reduce the frequency of your seizures

By taking steps to manage your condition, you can improve your quality of life and work towards living a healthier, more fulfilling life.

10 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Huff JS, Murr N. Psychogenic Nonepileptic Seizures. [Updated 2022 May 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441871/

  2. Devinsky O, Gazzola D, LaFrance WC Jr. Differentiating between nonepileptic and epileptic seizuresNat Rev Neurol. 2011;7(4):210-220. doi:10.1038/nrneurol.2011.24

  3. International League Against Epilepsy. By any other name: What to call psychogenic non-epileptic seizures?

  4. Auxéméry Y, Hubsch C, Fidelle G. Crises psychogènes non épileptiques. Revue de la littérature [Psychogenic non epileptic seizures: a review]. Encephale. 2011;37(2):153-158. doi:10.1016/j.encep.2010.04.009

  5. National Institute of Neurological Disorders and Stroke. Functional Neurologic Disorder.

  6. Bajestan SN, LaFrance WC Jr. Clinical Approaches to Psychogenic Nonepileptic SeizuresFocus (Am Psychiatr Publ). 2016;14(4):422-431. doi:10.1176/appi.focus.20160020

  7. Bakvis P, Spinhoven P, Giltay EJ, et al. Basal hypercortisolism and trauma in patients with psychogenic nonepileptic seizuresEpilepsia. 2010;51(5):752-759. doi:10.1111/j.1528-1167.2009.02394.x

  8. Walsh S, Levita L, Reuber M. Comorbid depression and associated factors in PNES versus epilepsy: Systematic review and meta-analysisSeizure. 2018;60:44-56. doi:10.1016/j.seizure.2018.05.014

  9. Labudda K, Frauenheim M, Illies D, et al. Psychiatric disorders and trauma history in patients with pure PNES and patients with PNES and coexisting epilepsyEpilepsy Behav. 2018;88:41-48. doi:10.1016/j.yebeh.2018.08.027

  10. Hingray C, Biberon J, El-Hage W, de Toffol B. Psychogenic non-epileptic seizures (PNES)Rev Neurol (Paris). 2016;172(4-5):263-269. doi:10.1016/j.neurol.2015.12.011

Arlin Cuncic

By Arlin Cuncic, MA
Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.