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Psychogenic non-epileptic seizures (PNES), also referred to as pseudoseizures, non-epileptic attack disorder (NEAD), functional seizures, or dissociative seizures, [2] [3] are episodes resembling an epileptic seizure but without the characteristic electrical discharges associated with epilepsy.
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]
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]
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]
Other post-ictal neurological findings that do not involve activity of the area affected by the seizure have been described. They are thought to be caused by a different mechanism than Todd's paresis, and including paralysis of the contralateral limb, [5] and rare genetic causes of hemiplegia and seizures. [6]
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, eg. syncope, psychogenic nonepileptic seizures, cardiac arrhythmia etc.
Status epilepticus is a seizure "lasting longer than 30 minutes or a series of seizures without return to the baseline level of alertness between seizures." [ 12 ] Epilepsia partialis continua is a rare type of focal motor seizure, commonly involving the hands or face , which recurs with intervals of seconds or minutes, lasting for extended ...
Otherwise, the lack of typical postictal symptoms, such as confusion and lethargy following convulsive seizures, may be a sign of non-epileptic seizures. Usually such seizures are instead related to syncope or have a psychogenic origin ("pseudoseizures"). [3] The postictal state can also be useful for determining the focus of the seizure.
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