Frequently Asked Questions

What is a psychogenic nonepileptic seizure?

A psychogenic nonepileptic seizure, known as PNES, ia a sudden changes in behavior, movement, sensation or awareness. They can vary in duration from short to very long and may represent a response to conscious and/or unconscious emotional distress or psychological conflict.

Is PNES a seizure?

No!

A seizure happens when there is a temporary change or disruption in normal brain activity with sudden bursts of abnormal electrical activity. There is no abnormal electrical activity in the brain during a PNES.

Go to "Is this a seizure?" to learn more.

Who gets PNES?

Children, adolescents and adults may all be affected by PNES.

  • PNES is more common in adolescents and young adults (ages 15 - 35).
  • Also, women are affected more often than men (about a 3:1 ratio).

What causes PNES?

PNES is a diverse and wide ranging disorder. There is no single cause of PNES.

  • About 4 out of 5 people with PNES have a history of psychiatric problems such as depression, anxiety and personality disorders.
  • There often is a history of sexual, emotional or physical abuse in people with PNES.
  • About half of people with PNES have a history of post-traumatic stress disorder (PTSD).

How does a psychological symptom become a physical symptom?

The symptoms of PNES usually reflect a psychological conflict or a psychiatric disorder. Often these problems are not processed on a conscious level. In most cases, PNES are not purposeful. Individuals are not aware that the events are non-epileptic and may become very anxious about having these symptoms.

Are there triggers for PNES?

PNES may happen spontaneously, even when a person seems relaxed, or may be triggered any of the following:

  • Physical symptoms (e.g., pain)
  • Strong emotions (e.g., anger), disturbing thoughts and memories
  • Something picked up by the senses (visual stimuli, noises, smells, etc.)
  • Difficult situations that a person experiences

How is PNES diagnosed?

The gold standard or best test for diagnosing PNES is a video EEG (electroencephalogram) that records the person’s brain electrical activity during a PNES. The EEG is normal when the event occurs - no abnormal brain activity is seen on the test despite physical or behavioral symptoms the person has.

Can psychogenic nonepileptic seizures be treated?

  • A person diagnosed with PNES is usually referred to a psychiatrist to treat any underlying psychiatric disorder that may require treatment with medication (e.g., depression, anxiety disorders).
  • They may also be referred to a psychologist or other counselor who will teach them strategies to manage stress and overcome psychological symproms.
  • Cognitive Behavioral Therapy is one type of therapy that can be an effective treatment for PNES.
  • Antiseizure medications do not help treat the PNES episodes.

Does PNES ever go away without treatment?

Between 20 to 50% of people stop having PNES once the diagnosis is made and without any specific treatment. This happens more commonly in children. Other factors that make remission more likely include a short history of PNES and presence of only mild, not severe, psychiatric symptoms.

Can a person with PNES also have epilepsy?

Yes, it is possible for a person to have both PNES and epilepsy. Up to 25% of people with PNES also have epilepsy. Your neurologist, along with a team that includes a psychologist or psychiatrist, will help you to make sure each condition is appropriately treated. The treatment for PNES is different than the treatment for epilepsy.

Authored By: 
Elaine Kiriakopoulos MD, MSc
Authored Date: 
10/2019
Reviewed By: 
Andres M. Kanner MD
Patty Obsorne Shafer RN, MN
on: 
Tuesday, October 1, 2019