Psychogenic seizures are episodes characterized by convulsions and a loss of motor control that are not caused by unusual electrical activity in the brain. Such episodes are caused instead by intense stress or emotional turmoil and do not have a well-understood physical origin. Epileptic seizures, on the other hand, are caused by abnormal electrical discharges, so similar symptoms with psychogenic origins are commonly referred to as psychogenic non-epileptic seizures. Psychogenic seizures are also sometimes referred to as "pseudoseizures," though this name is not widely used, as the lack of an understood physical mechanism for seizure symptoms resulting from stress and emotion does not make the convulsive episodes any less real.
Epileptic and psychogenic seizures appear very similar, so it can sometimes be difficult to distinguish the two. There are a few differences between the seizures of epileptics and non-epileptics, such as triggers and particular movements, but these are by no means conclusive. The most conclusive diagnostic test for psychogenic seizures involves the relatively long-term use of electroencephalography, or EEG, sometimes accompanied by video surveillance. EEG tests monitor electrical activity in the brain and can be used to determine if abnormal electrical discharges accompany a seizure, indicating epilepsy. These tests are sometimes carried on for days or weeks with accompanying video in order to collect and correlate observed seizure behavior with EEG electrical data.
It should be noted that while psychogenic seizures have psychological and not physical origins, they are by no means "fake" seizures. There are cases in which individuals fake seizures for psychological reasons, for some personal gain, or to avoid some loss or punishment. In these cases, the individuals pretending to be experiencing a seizure are in complete control of their simulated symptoms. People who suffer from psychogenic seizures, on the other hand, do not have control over their symptoms. Their seizures are involuntary in nature and are not calculated acts intended for personal gain.
Misdiagnosis of psychogenic seizures can be costly and harmful to patients. Psychogenic seizures that are misdiagnosed as epileptic seizures may be treated with anticonvulsant medications or even surgery. Both options are quite costly and both can have unpleasant side effects. Misdiagnosis is, however, relatively rare given the ability of medical professionals to detect anomalous brain activity.
Most of the treatments for seizures with psychological origins are based in psychotherapy. Seizures can be reduced or prevented by discovering and addressing the precise psychological origins of the seizures. In some cases, other psychological illnesses, such as depression, may be closely related to the seizures; medications such as antidepressants are often used in such cases.