What is PNES?
PNES stands for psychogenic non-epileptic seizures. This means that the seizures that the patient experiences aren’t caused by abnormal electrical problems inside their brain. Doctors believe that the seizures are more psychological in origin. Though few people have heard of the disorder, it is surprisingly common. For example, one in three people who go to the epilepsy program at UCLA to be treated for their seizures discovers they do not have epilepsy but are suffering from psychogenic non-epileptic seizures. However, people who do have epilepsy can also suffer from PNES.
Who gets PNES?
Most sufferers are young women and people with mental illnesses, including depression, post-traumatic stress disorder, personality disorder, and anxiety. This leads psychologists to believe that the seizures are their bodies’ response to their psychological distress. Because of this, treatment may focus on healing the patients’ trauma and mental health issues.
The DSM-5, or the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders describes PNES as a conversion disorder. A conversion disorder is a condition where a person experiences a state such as blindness, paralysis or seizures, but doctors can find no medical reason for it.
The symptoms of PNES look very much like the symptoms of epilepsy. The patient may have the sort of convulsive seizure where their body stiffens, they fall to the floor, and their arms and legs jerk uncontrollably. They may bite their tongue or become incontinent. Some people have the type of seizures where they seem to stare off into space. But unlike epilepsy, the seizures are more likely to occur in front of people and can be interrupted by a bystander. The patient also remains aware during their seizure and can remember it.
A patient with PNES can have a seizure that lasts as long as a half an hour, which is called non-epileptic status. A person with epilepsy risks brain damage after a seizure that lasts that long, but a person with PNES does not. When the seizure is over, the PNES patient does not have a headache nor are they fatigued. Their breathing after the seizure is shallow and quick, while the breathing of patients with epilepsy is deep and harsh.
Medication that can control epilepsy does not work with PNES. The most effective PNES treatment is psychological counseling, especially cognitive behavioral therapy. Counseling is important because PNES patients are often dismayed because their seizures are not caused by epilepsy. Moreover, their families, friends, and coworkers may believe they are malingering. On the other hand, the seizures of some people with PNES do stop when they realize they don’t actually have epilepsy.
PNES can be a very confusing and frustrating condition to understand. If the seizures are not caused by an electrical malfunction in the brain the best route is to begin to understand what is the root issue. Learn more about our PNES Intensive Outpatient program by calling 214-522-4640 today to schedule a consultation.