Harvard Mental Health Letter

In Brief: When is it epilepsy?

In Brief

When is it epilepsy?

In vulnerable people, emotional conflict, stress, or an abnormal need for attention can result in symptoms that uncannily resemble true epileptic seizures. These episodes, once called pseudoseizures, are now usually called psychogenic nonepileptic seizures or attacks. Psychiatric disorders, especially conversion disorder are a common cause. As many as 20% of patients with genuine epileptic seizures may also have psychogenic seizures.

The most reliable way to tell the difference is to measure brain electrical activity during the episode with electroencephalography (EEG). Video recording of the event can also be helpful. But these methods are not perfect and, more important, are often not available in an emergency. Two papers published in 2006 in the journal Neurology suggest other tests that can be used during and shortly after a seizure.

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