Psychogenic non-epileptic seizure

Psychogenic non-epileptic seizures (PNES), also referred to as functional seizures or dissociative seizures,^[1][2] are episodes that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain.^[3][4] Instead, they are classified as a type of functional neurological disorder (FND), in which symptoms may arise from changes in brain function rather than structural disease or epilepsy. During a PNES episode, seizure-like behavior occurs in the absence of epileptiform activity on electroencephalogram (EEG).^[5]

PNES can be difficult to distinguish from epileptic seizures based on clinical observation alone. Diagnosis is typically confirmed through video-EEG monitoring, which records both the clinical event and the absence of epileptiform activity. These episodes are involuntary and genuine, not consciously produced. Management primarily involves psychological treatment, particularly cognitive behavioral therapy (CBT). Outcomes vary and may be influenced by factors such as early diagnosis, therapeutic engagement, and coexisting psychiatric conditions.^[6][1]