What is PNES?
Dissociative seizures, also known as Psychogenic Non-Epileptic Seizures (PNES), are episodes that look like epileptic seizures but are not caused by abnormal electrical activity in the brain. They are a common manifestation of FND.
Important Distinction
Characteristics of PNES
While they appear similar to epilepsy, dissociative seizures often have distinct clinical characteristics that a specialist can identify:
- Duration: Often longer than the 1-2 minutes typical of an epileptic seizure.
- Eyes: Often tightly closed during the episode (whereas in epilepsy they are usually open).
- Side-to-side movement: Rhythmic head shaking or side-to-side body movements are more common in PNES.
- Recall: Some patients remain semi-aware or can hear what is happening but cannot respond.
Why do they happen?
The "Overload" Theory
The brain may use a seizure-like episode as a "circuit breaker" when it becomes overloaded by physical pain, sensory data, or emotional stress. It is a profound form of dissociation where the mind temporarily disconnects from the body.
How are they diagnosed?
The "gold standard" for diagnosis is Video-EEG monitoring. If a patient has a typical episode while connected to an EEG and no abnormal electrical discharges are seen, it confirms the seizures are dissociative (functional) rather than epileptic.
Anti-Epileptic Drugs (AEDs)
Management & Recovery
Recovery is possible. Many patients find that their seizures stop or decrease significantly once they understand the diagnosis and learn to recognize "warning signs" (auras) that an episode is coming.
- Psychoeducation: Understanding that the seizures are a brain-software issue.
- Grounding Techniques: Tools to "stay in the moment" when warning signs appear.
- CBT: Specialized therapy to address the brain's "emergency response" system.