What Are Non-epileptic Seizures?

Non-epileptic seizures are often caused by factors such as stress or a physical condition.

The initial physical symptoms and signs of NES are much like epileptic seizures, including confusion, loss of awareness, convulsions and even loss of consciousness. However, a key difference is that there is no change in brainwave electrical activity in a non-epileptic seizure. Whereas during an epileptic seizure, there is a pattern of sudden electrical discharges in the brain, which causes an interrupted transmission of electrical signals.

What Do Non-epileptic Seizures Look Like?

NES presents in different ways. People may experience various symptoms that are caused by factors beyond their control, including:

  • Stress and stressful events
  • Medical conditions 
  • Psychological trauma
  • Physical abuse

Other examples of non-epileptic seizures include:

  • Syncope – a fainting episode caused by a sharp drop in blood pressure, heart-related conditions or dehydration. Within a syncope episode, people lose consciousness and can experience convulsions. 
  • Psychogenic non-epileptic seizures – are caused by psychological factors like trauma or stress. These seizures can look like epileptic seizures. However, they last longer and may not respond to specific medications.
  • Migraine – People experiencing migraines may also experience some types of seizures. During these episodes, people see flashing lights, have difficulty speaking or may experience numbness in their limbs.
  • Neurological conditions – conditions such as dystonia, myoclonus or chorea cause sudden movements that may resemble seizures. However, these movements don’t affect consciousness. 

If you or a loved one experiences seizures, it is vital to consult your GP. Early assessment, support from medical teams, and care are crucial for positive outcomes.

Types of Non-epileptic Seizures

NES presents in several ways and can be caused by organic, physical and psychological risk factors. Some people with PNES may look like they are experiencing generalized convulsions and body spasms similar to epileptic seizures. The next section of our guide will provide a detailed explanation of the different types of NES. This will help you better understand non-epileptic seizures and how to respond if someone experiences a seizure.

Dissociative Seizures

Dissociative seizures cause a state of dissociation, and people can experience multiple epilepsy-like symptoms such as uncontrolled movements, loss of awareness and even loss of consciousness. The main reason behind dissociative seizures can be pinpointed to traumatic events, severe mental stress and poor mental health.

It is essential to know that people who experience dissociative seizures feel disconnected from reality during a seizure.

Common symptoms of dissociative seizures include:

  • Convulsions 
  • Jerking movements 
  • Losing awareness 
  • Losing consciousness 
  • Muscle paralysis 
  • Staring into space
  • Muscle stiffness 
  • Sensory changes 
  • Loss of bladder control

Non-epileptic Seizures with Organic Cause

Non-epileptic seizures that have an organic cause are usually triggered by other health conditions like diabetes, heart conditions, low blood pressure or even alcohol misuse. Organic non-epileptic seizures are often easy to identify, and also they are simple to manage and treat. For instance, if a person loses consciousness due to a particular heart condition, the treatment plan and medical team will aim to rectify the underlying problem and prevent future episodes.

Non-epileptic Seizures with Psychological Causes

Psychogenic nonepileptic episodes are caused by psychological factors. PNES symptoms often include experiencing generalized convulsions similar to tonic-clonic seizures, twitching, and side-to-side head movements.

Psychogenic nonepileptic spells can be caused by:

  • Panic attacks – For some people in highly stressful or scary situations, panic attacks can cause seizures due to extreme fear and anxiety
  • Factitious seizures – are rare seizures where people can purposely cause the seizure due to their need to seek medical attention, treatment and observation
  • Trauma – People who have experienced severe trauma in their lives are more likely to develop PNES symptoms
  • Functional neurological symptom disorder – it is considered that PNES is a form of FND and is often characterised by involuntary movements and altered consciousness
  • Certain Mental health challenges

Non-epileptic Seizures Symptoms

The symptoms of non-epileptic seizures vary among individuals, but they often resemble epileptic seizures.

The most common symptoms of NES include:

  • Convulsions 
  • Twitching
  • Numbness
  • Stiffening of the muscles 
  • Loss of awareness 
  • Loss of bladder control 
  • Biting the tongue 
  • Consciousness confusion
  • Repetitive movements 
  • Loss of balance 
  • Making uncontrollable sounds 

Not all seizures are caused by epilepsy, which is why an evaluation by a neurologist is essential to diagnose and treat seizures. Additionally, these seizures can be caused by psychological factors, which is why psychotherapy or other forms of psychological support can be beneficial as a way of treatment. 

Non-epileptic Seizures in Children

Non-epileptic seizures can also happen to children, but they are less common. NES in children can be caused by anxiety, depression, post-traumatic stress disorder or any other severe emotional stress. The symptoms of PNES in children include:

  • Convulsions
  • Jerking movements 
  • Losing consciousness 
  • Losing awareness 
  • Holding your breath 
  • Sensory changes 
  • Unusual body movements 
  • Muscle stiffness 

Diagnosing NES in children is challenging as their symptoms are difficult to differentiate from epilepsy-like seizures. A comprehensive evaluation by paediatric neurologists and other mental health professionals is necessary to diagnose and develop a care and support plan properly.

Treatment for non-epileptic seizures in children involves various therapies like play therapy, cognitive-behavioural therapy or other stress-reducing methods if needed. Treatment aims to help children manage stress better and understand their emotions. 

What Causes Non-epileptic Seizures?

Non-epileptic seizures are caused by emotional distress, trauma and other psychological factors. In some cases, they have a physical cause. All of us face emotional challenges in life, and these experiences can have a long-lasting impact on our mental health. In some cases, these seizures are a way for some people to cope with trauma.

The causes of NES include:

  • Life-altering accidents 
  • Severe stress and trauma 
  • Bullying 
  • Challenges with the nervous system
  • Physical conditions

What Triggers Non-epileptic Seizures?

It is a challenging task to identify what triggers explicitly non-epileptic seizures and to pinpoint what intense reaction caused a person to have a seizure. For some people, NES occur shortly after a specific trigger; for others, it can happen years later for no apparent reason. Some people even develop a fear of having a seizure, which can trigger a seizure due to intense stress and anticipation.

Non-epileptic Seizures While Sleeping

Non-epileptic seizures can happen during sleep as well. During sleep, seizures are characterised by abnormal breathing patterns, blood pressure changes or sudden movements of the arms and legs. Other symptoms may include convulsions, shaking, sweating and sleep disruptions.

To rule out NES during sleep, it is essential to consult with a healthcare provider who will recommend performing an electroencephalogram or EEG to rule out epilepsy and other conditions.

For others, psychological therapy may be helpful to understand the emotional factors contributing to a non-epileptic seizure. Treatment options usually involve lifestyle changes, medication and family therapy.

Non-epileptic Seizures and Driving

Seizures can happen at any time, and this doesn’t exclude driving. If you have received an NES or PNES diagnosis, you will most likely have to pause driving and inform the Driver and Vehicle Licensing Agency. If you go through three months without having a seizure, you can apply for a new driving license.

Seizure Care and Support with Nurseline Community Services

At Nurseline Community Services, we aim to support people with complex care needs through our dedicated healthcare team, bringing kindness and dedication to every individual we serve.

Nurseline Community Services provides tailored complex care for any health needs. Our clinicians support people with epilepsy, NES, and mental health needs. We offer support services for people in the comfort of their own homes.

Contact us today so we can create an individualised care plan tailored to your needs.