Non-Epileptic Seizures and Treatment

Non-epileptic seizures. Psychogenic seizures. Non-epileptic attacks. These are all just different names for the same problem – seizures that are triggered by physical and psychological changes instead of neurological ones (as with epilepsy which is causes by neurological changes in the brain.)
In simple terms, these “attacks” or seizures are physical symptoms that are triggered by any sort of physical stress (such as a headache, not getting enough sleep, or an injury) or emotional stress (such as anger, sadness, disappointment, anxiety, or depression.)
Now, the term “seizures” can be somewhat misleading if you are trying to better understand this condition because the symptoms may not look like what you would imagine a seizure to be. People who struggle with psychogenic non-epileptic seizures (PNES for short) may not suddenly drop to the ground and begin violently convulsing as with an epileptic seizure. They might, but they might not. The symptoms of PNES vary widely from person to person but may look something like this…

1) The person is functioning just fine for the day, but then encounters a situation that causes them to experience physical or emotional stress. Perhaps they haven’t gotten enough sleep, maybe they’re thinking about an unresolved conflict they have with someone, of maybe they’re feeling a bit worthless because they’ve been having such a difficult time lately.

2) They begin to notice their symptoms starting. Perhaps they begin to feel dizzy, perhaps things start to feel surreal, or perhaps they start to lose their balance or have trouble walking or standing.
3) They may try to rush through what they’re presently doing to get to a “safe place” before the really difficult symptoms begin.
4) The symptoms worsen and they may begin falling suddenly, lose their ability to speak and become slurred or incoherent, or they may begin to twitch.
5) At this point, many people with PNES seek safety by lying down in bed to wait it out. Their symptoms often continue to worsen and they may begin experiencing sudden jerking or contorting of their arms, legs, shoulders, or torso. They may begin to lose awareness for several seconds and become nonresponsive only to “come back” with no awareness of what has happened in the past few moments.
6) The symptoms often continue until the person falls asleep due to either physical exhaustion or with the help of medications such as Klonipin to help calm them down.
7) The person wakes up and spends the first few moments trying to determine if they are “okay” or if the symptoms are still there. And on the cycle goes unfortunately.

non-epileptic seizure treatment

Who Can Diagnose Non-Epileptic Seizures?

This is an exhausting and devastating condition to individuals who suffer from it as well as their families. If you think you may be experiencing these types of symptoms, it’s crucial to be evaluated by a neurologist who can perform an extended EEG with video monitoring to provide you with an accurate diagnosis of your condition. It’s important to seek out a specialist who is familiar with this condition and who can rule out traditional epilepsy as a cause if that’s the case.
Once other possible causes have been ruled out, all the tests and observation have been done, and you’ve received a diagnosis – then it’s time to begin learning about treatment options. If you’ve been diagnosed with PNES and are interested in possible treatment, its important to educate yourself on the various forms of treatment to determine which you’d like to try.

What’s The Treatment for Non-Epileptic Seizures?

The three primary treatments for non-epileptic seizures include medication, EMDR, and cognitive behavioral therapy. Here you’ll find a bit of info about each to help you get a better idea.

Medication treatment for non-epileptic seizures often includes anti-depressant or anxiety medications to help manage symptoms.

Remember that the physical symptoms are triggered in part by emotional stress, so the purpose of these medications is to limit your ability to experience the emotions that trigger your symptoms. For example, if anxiety often triggers your symptoms, you may be prescribed a medication called a benzodiazepine that limits your body’s ability to experience the physical sensations of anxiety. Similarly, if depressive moods typically trigger your symptoms, you may be prescribed an SSRI which acts to limit your ability to experience depressive moods. These medications can certainly be helpful for many individuals, but often cannot do much to protect from physical triggers such as sleeplessness, illness, injury, etc. To find out more about medication options, ask your neurologist for a referral to a psychiatrist in your area that is familiar with PNES.

EMDR is often one of the top recommended therapies for non-epileptic seizure treatment because it is a form of therapy that focuses on helping you to process past trauma.

EMDR uses a combination of techniques to help you process unconscious mental and emotional distress related to traumatic experiences. If you have a history of trauma such as physical, sexual, or psychological abuse this form of treatment can be very helpful in working through it. The challenge with this form of treatment is that it typically causes more symptoms initially since you will be confronting and coping with painful memories and emotions that often trigger your symptoms. As such, it’s important to have a dependable support person to assist you with transportation, assistance with daily tasks, and emotional support throughout the process.

Cognitive Behavioral Therapy (CBT for short) is another therapy recommended for non-epileptic seizure treatment because it helps you begin learning about your condition, why and how it has developed, and begin identifying and coping with your triggers.

This form of treatment focuses primarily on changing your understanding of your condition, gaining insight into yourself and your inner experience as it relates to your physical symptoms, and learning coping skills to help you manage triggers. Oxford Clinical Psychology offers a CBT treatment program that can be completed with a trained cognitive behavioral therapist through the use of a workbook, which has been found to be highly effective for many individuals.

Keep in mind, this is not by any means an exhaustive list of the treatment options as I’m sure there are many available, but there are the ones I most often hear about. If you or someone you know is experiencing non-epileptic seizures or you are interested in learning more about non-epileptic seizure treatment, please contact me at 407-603-6132 for more information or to set up an appointment.

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