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PNES episodes can be difficult to distinguish from epileptic seizures without the use of long-term video EEG monitoring.Some characteristics which may distinguish PNES from epileptic seizures include gradual onset, out-of-phase limb movement (in which left and right extremities jerk asynchronously or in opposite directions, as opposed to rhythmically and simultaneously as in epileptic seizures ...
Physiological causes include fainting, sleep disorders, and heart arrhythmias. [2] [3] Psychological causes are known as psychogenic non-epileptic seizures. [3] Diagnosis may be based on the history of the event and physical examination with support from heart testing and an EEG. [3]
Breakthrough seizures are more likely with a number of triggers. [54]: 57 Often when a breakthrough seizure occurs in a person whose seizures have always been well controlled, there is a new underlying cause to the seizure. [55] Breakthrough seizures vary. Studies have shown the rates of breakthrough seizures ranging from 11 to 37%. [56]
Usually, the physical symptoms of the disorder affect the senses or movement. Common symptoms included blindness, partial or total paralysis, inability to speak, deafness, numbness, difficulty swallowing, incontinence, balance problems, non-epileptic seizures, tremors, and difficulty walking.
Because epileptic seizures typically include convulsions, the term convulsion is often used as a synonym for seizure. [1] However, not all epileptic seizures result in convulsions, and not all convulsions are caused by epileptic seizures. [1] [2] Non-epileptic convulsions have no relation with epilepsy, and are caused by non-epileptic seizures. [1]
One retrospective observational study evaluated 328 selected patients from ages 16 to 57 years who had prolonged video-electroencephalogram (EEG) monitoring for medically intractable epilepsy and focal seizure onset; those with nonepileptic seizures, status epilepticus, and Lennox-Gastaut syndrome were excluded.
Diagnosis of epilepsy can be difficult. A number of other conditions may present very similar signs and symptoms to seizures, including syncope, hyperventilation, migraines, narcolepsy, panic attacks and psychogenic non-epileptic seizures (PNES). [133] [134] In particular, syncope can be accompanied by a short episode of convulsions. [135]
The goal is to record 3-4 typical seizures, though in some cases more or fewer seizures may need to be recorded. After this evaluation, some patients may be determined to have non-epileptic causes of their symptoms, e.g., syncope, psychogenic nonepileptic seizures, cardiac arrhythmia, etc.
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