Psychogenic nonepileptic seizures (PNES): A review

Abstract

Psychogenic nonepileptic seizures (PNES) are observable abrupt paroxysmal changes in consciousness or behaviour that present similar to epileptic seizures but are not accompanied by the electrophysiological changes associated with epilepsy and there is a strong suspicion or positive evidence for existence of a psychogenic cause. There is no single feature that absolutely distinguishes true epileptic events from psychogenic nonepileptic seizures and hence there is considerable diagnostic uncertainty for the condition. This is well evidenced by the fact that there is an average delay of approximately 7 years before the right diagnosis of ‘psychogenic seizures’ is achieved. Hence, this leads to an enormous social and economic burden on the society with costs incurred upon ‘PNES’ approximating that of refractory epilepsy group. This review focusses on the salient clinical pointers to the condition along with possible diagnostic and treatment strategies.

Keywords

• Psychogenic nonepileptic seizures
• psychogenic seizures
• PNE