Is there a treatment for psychogenic non epileptic seizures?
Yes, but…
There are a myriad of factors that can affect the prognosis (whether the outcome will be good or bad).
What are some of the factors we know support a good prognosis?
1) The sooner the right diagnosis is made. That avoids the condition becoming chronic and the suffering. But on average patients spend 5-7 years before they obtain the correct diagnosis of PNES.
2) That the diagnosis is reliable. In order for this, Video-EEG monitoring is proposed as the gold standard.
3) The way in which the diagnosis is communicated to the patient by her/his neurologist, psychologist, or psychiatrist when the diagnosis is made. If the explanation is clear and respectful, the patient is able to understand it as well as the treatment recommendations.
4) Ideally, the patient doesn’t leave the hospital without a psychological referral in hand but the key word here is “ideally.” Unfortunately, there are few epilepsy centers that report having mental health professionals to whom they can refer PNES patients.
What about treatment? There is no one treatment designed specifically for PNES. Why? I think that this is because non-epileptic events are only the tip of the iceberg. To treat PNES, we have to target what is fueling them: the way in which stress, anger, frustration, fear, sadness, trauma, and more are affecting you. Since each person is different and life is also constantly happening treatment will need to adapt to each individual. Ergo, there is no one form of treatment that works.
There are many types of treatments: interpersonal, psychodynamic, cognitive behavioral, mindfulness techniques, trauma-specific-treatments, etc. There are also a number of psychiatric medications that can help. All of these interventions have shown that they can be useful. Elimination of seizures or significant reduction in numbers has been reported in about a 1/4 to over 1/2 of cases using any one or a combination of these techniques.
Today’s take home message: Treatments are available. Points 1-4 mentioned above are where we need to be focusing our efforts as professionals and as the PNES community. This will pave the way to get patients with PNES to that treatment.
17 Responses to “Is there a treatment for psychogenic non epileptic seizures?”
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Psychological non epileptic seizures (also known as PNES) are behavioral events that look a lot like epileptic seizures (ES), but are in fact produced by emotional stress rather than electrical disruptions in the brain.
This article is good. My husband suffered from PNES and one hospital saw he was having sz but nothing abnormal with EEG and they Know about PNES but never dx. They just giving hom med upon med. we took him to another hospital and within two days of his stay they dx and he started therapy and since then his sz have dramatically decreased
Thanks for sharing that, Jerri and for the kind words. It is good to hear that you and your husband had that experience of getting the correct diagnosis and being able to move in the right treatment direction. It is really essential.
I am a clinical psychologist, 70 years old, have a 90 year old mother who has had psychogenic disorders and caused us to suffer for my entire life. She has been diagnosed with pseudo-epileptic seizures by highly respected practitioners and institutions, including the University of Michigan Medical Center. She has refused to accept the diagnosis and over the years has also added pseudo-TIA’s. She has adamantly and angrily argued that “it is not emotional” despite all evidence and many respectful presentations. She has also managed to get doctors to do many, many tests, including a sleep specialist/neurologist who diagnosed narcolepsy and prescribed Depakote. Psychotropic and other medications have been prescribed.
I am certainly no looking for any suggestions, but I hope this account will help others in this more enlightened time to get the right help very soon in the course of this condition. I would highly recommend two things for the families:1) family therapy,2)a wonderful book, The Body Speaks.
Lynda Paull,Ph.D.
NYSPA member
Hi my daughter is 16 years old and has PNES
At least we think so She has had normal EEg . She gets intense dejavu seizures and I know some people might not like that word but that is exactly what they are It is just that they stem from a physical or emotional trigger not from an abnormality in the brain which is epilepsy. She has had anxiety and depression and is on medication(low dose antidepressant)but this doesn’t seem to be helping .Her doctor is doing everything he can to help.It seems that the more stressed she is the higher the frequency of the PNES Can anyone tell me if this is going to improve and what methods have you found which has helped to lessen these episodes. As a mother I am at my wits end to help my daughter. She wasn’t at school last year and they did lessen and she had months free of seizures which seems to be because of less stress. Can anyone help Thanks
I work with adults and adolescents with epilepsy and non-epileptic seizures. Lorna, your post is very sensible and important, particularly the way in which the PNES is communicated to the patient. I find that often the patient is looked down upon because they don’t have a “real” disorder and this sabotages treatment before it even starts.
I wonder if you can help? Since the age of 17yrs, I have suffered with numerous feelings and emotions that have changed over time. I was diagnosed of suffering from panic attacks and depression/anxiety. I recently informed my new surgery of what happens and I am now under the hospital. I have had 2 EEG’s which show ‘blips’ whereas I have also undergone an MRI scan, this was clear and showed no indication of epilepsy. The Dr is still insisting he cannot diagnose that I have or do not have epilepsy. Having read up on PNES, I am finding the symptoms etc are very much the same and I have had traumatic effects during my life, as a young child and as a 17yr old. Please could someone help??
What help do you need? If you are looking for more information, you might look at a few different websites: http://www.nonepilepticseizures.com/index.php. Also: http://www.nonepilepticattacks.info/index.html (created by Dr. Markus Reuber (a fantastic researcher and clinician who is in England) and of course: http://www.neadtrust.co.uk/
Hi Shahal, thank you for that comment. It is always fantastic to hear like-minded experiences. I see you on the NYSPA listserv sometimes. Where is your practice (you can email me)and what insurances do you take. I would like to add you to my PNES website’s referral list.
Looking for help…. My son has been having non-epileptic seizures on and off for about 2 years now. The events will usually last about 2-3 days having as many as 8 seizures a day at it’s peak and decreasing. Each seizure lasting the most 60 seconds. There will also be very large amounts of time between each event anywhere from 2-9 months. We think they are finally gone but they rear their ugly head again. Has been to 3 hospitals and all tests are negative. He has has EEG, CAT scan, MRI, Spinal tap. The most recent episode was a little different. He had one seizure with alot of head pain on a Saturday then another one on a Sunday and that was it. The difference with the last 2 is that he had head pain where in the past he didn’t so that’s why hospital ran extra tests. He has been seeing a psychologist for a while, but I was wondering if anyone can share advice with their experiences. Thank you.
I have had PNES for about four years. It was triggered when I began remembering traumatic events from my childhood that I had forgotten about my whole life.
Getting treatment in the current medical community seems very difficult. Despite having been a successful professional woman formerly, I was looked down upon by all of the medical professionals who attempted to treat me at the time, and most of them treated me dismissively, which exacerbated my stress and confusion going through a very traumatic medical situation.
Diagnosis, and the delivery of that diagnosis is critical. However, once I had the diagnosis, I felt largely abandoned by the medical community.
Finding a psychiatrist and therapist who are comfortable treating PNES was very challenging for me.
I just wanted to share some of the treatments that for me made the most difference:
1. EFT – Emotional Freedom Technique
This was by far the most successful in helping me with my PTSD and seizures. My coach was phenomenal and because of his great work with me, I am still alive today.
2. The PTSD Mind Body Workbook – a Therapist had me go through this wonderful book and I did it during the same time period where I worked with my EFT coach. It only takes about 15 minutes a day and it dramatically improved my ability to function.
Currently I still have seizures occasionally. However they have gone from several full-blown grand mal seizures a day to much less frequent partials with an occasional grand mal.
I wish everyone the best of luck in treating this condition!
While I was on contract in Iraq I was told I had seizure. I was given all the tests and of course nothing neurological was found. I was told I had PTSD and I resigned my job. Since then I have had 2 more rounds of tests each with same results. I have been denied Disability and MEDICAID. I have had several seizures resulting in head injuries and a car wreck. I do not drive anymore nor have I worked in 2 years. I may be forced to take early retirement with not enough money to support myself. My reason for not working is the dis associative amnesia I have after an episode. The Drs. don’t seem to know much about this condition. I have no medical coverage. What do you suggest?
Overthrow the corporate government, replace it wih actual competent law makers and people who aren’t corrupt, and instill universal healthcare and invest in more medical research.
I have been living under extreme stress for a little over 2 years due to job and family strife coupled with forclosure and the loss of my financial solvency. I also stopped drinking alcohol and using drugs about the same time. In the last 6 months, I have had 3 seperate attacks, the last 2 being multiple seizures. Each attack was preceded by an emotional upset. I am 46 with no history of seizures until 6 months ago. I just qualified for Major Medical through my employer. Does anbody have any advice as to where to start looking for treatment? I live in Southern Michigan.
LORNA MYERS- could you please send me info on your referral site? My email is Jocelynalexandria@hotmail.com. Thank you very much!!!
My 13 year old son has been having PNES for two years. They began after a mild concussion. All tests were negative including a 36 hour V-EEG in the hospital which helped in his diagnosis. Stress from school is the major trigger. He never has them over the summer. He sees a psychiatrist for an anti-anxiety medication, but it doesn’t always help. Can you refer him to a psychologist who is trained in PNES? We live is SW Broward County, Florida. Thank you!
My daughter has PNES. She is 16 years old. She was fainiting daily. She stopped going to school. She now studies at home.
She wanted a dog badly. We got a dog. Then the fainting become only 1 to 2 times a week. The dog has been great! She is looking after the dog. Therefore she must be more focused on the dog. She can not faint. This has been GREAT! I hope this may help people. I hope helps someone….
Hey I’m 17 years old and I live in South Africa. In the past few months I’v seen 4 neurologists, 4 psychologists, 4 general practitioners, 2 psychiatrists and 2 physicians. I received treatment during the holiday at a clinic. I was put on an anti-depressant. Since I started with school again the attacks started. Luckily it doesn’t really happen at school but in the afternoons and late evening I still get the attacks. I’m at my wit’s end. My mother and sister have gone through tremendous stress since I got diagnosed. I just want 2 find some kind of relief. I’m in my last year of school. Can anyone mayb give some advice as to how 2 decrease the attacks? Thank you