How to differentiate between epilepsy and pseudo-seizures

[LovebugLPN]

I have seizure disorder (according to 3 neurologists) but getting the correct dx was a hard thing that took a lot of time and testing. It has never shown up on an EEG (and I have had 3 of 'em) and every MRI and PET etc has shown nothing. What I have always wondered is how can doctors diagnose one person with epilepsy and the next person with pseudo-seizures when both people have negative EEGs? What happens if they stop someones meds for epilepsy because they believe they are having pseudo-seizures and they are really have seizures that really just never show up on tests? How do they make they make the dx with no concrete proof?

[angelsabove7777]

I just want to relay my experience... I have epilepsy and work in the medical field.

But during one of the many trips to the ER trying to get help for this in the wee hours of the night while I was so new to it were complicated and frustrating to me.

The frustration came from the lack of belief. It was assumed that I had pseudo epilepsy obviously.

I was so upset and crying especially after one of the physcians, who happened to also be the Director, had left me along side the nurses station on a stretcher while he yelled at me in front of others. He yelled that I was using up space others needed. Further, he insisted that I did not have a seizure, nor epilepsy.

So I left AMA crying my heart out, I was so embarrassed.

Well, the following day I happened to have an EEG that had been ordered from my own primary physician scheduled at that very same hospital.

I was so hesitant but took it anyway. And I am glad I did.

THe EEG showed an abnormal study: Findings are consistent with epileptiform discharge arising from the left frontotemporal region.

I was having a series of recurrent seizures obviously.

I was so tempted to flash my report right in front of that Director/physician at that ER especially! I didn't though.

[HeatherISU]

I have epileptic seizures, possibly over a dozen or so, but have never been incontinent of urine.

I'm interested in pseudo seizures. I have never heard the term...

Also, I was diagnosed at first with a "seizure disorder" and later they called it epilepsy. No EEG for the diagnosis. My neurologist said that since I was having recurrent seizures, it was termed epilepsy. I have auras and a post ictal period.

[maria203m]

I have epilepsy since i was a baby, i've been having having partial seizures since then.

about 6 months ago, i was diagnosed with anxiety and pseudo seizures. i'm now taking antidepressants and anti-convulsive drugs. since my seizures have always been partial, is so hard to differentiate between an epileptic seizure and a pseudo-seizure. i don't see of feel any difference between them.

[Phoenixbyrd]

If someone is faking seizures They will stop when they are exposed to ammonia sniffer things.

How would the person experiencing true epileptic seizures react after being exposed to ammonia? Would they react (jerk head away) but continue to seize?

I know this is an old post, but I'm interested in knowing

[xtxrn, ASN, RN]

M step-mother was diagnosis with pseudo-seizures and one way they mentioned was that she didn't lose bowel/bladder control. Also, the post-tical period was non-existent.

Not always definitive, depending on how long it's been since they voided, and type of seizure (for true seizures). There are dozens of types of seizures, and even within a specific type, each person will have different symptoms - though the pattern of the seizures for that person is generally consistent.

A lot of times people w/"real" seizures have negative tests....but they may have witnesses who contribute valuable information. Video EEGs will weed out the pseudo-seizures and conversion disorder episodes, if an episode is captured on tape and compared w/the EEG. If the source of the seizure is reachable without causing severe neuro impairment, it can be removed; with kids, a hemispherectomy can be done, and many kids do very well, and don't have further seizures.

Even in witnessed/documented seizures (speaking personally), there may be more than one type of seizure. A simple partial can happen on its own, or spread to become a complex partial or even generalized. The focus of the seizure will also make it easier or harder to detect- some seizures start so deep in the brain that scalp electrodes can't pick them up. Others show up on EEGs, but it may take a 24-48 hour extended EEG to capture abnormal waves. The 20 minute EEGs can be useless, depending on the person. And, they can be different in how they show up from EEG to EEG (last year, there was slowing on the right, this year irritability on the left; video= L temporal lobe sharps when drifting off to sleep; after severe hypotensive episode- generalized slowing.

It's all very individualized.

[kessadawn, BSN, RN]

Pseudo-seizures aren't always people who are "pretending to seize". I actually wanted to have a dx of pseudo-seizures because it meant having my life back and my driver's license. All the neurologists said you couldn't tell someone having a true seizure from someone having a pseudo-seizure unless it was someone truly faking it. Their are a lot of people who have pseudo-seizures who truly believe they are having a seizure and don't have any control over it. I was just wondering how if every test came back normal, as can be the truth in either case, do they make the dx of seizure disorder.

I hate the connotation that the word "pseudo seizure" brings. Pseudo seizures are NOT faked, the patient has no control of the occurance in any way shape or form. Pseudo seizures are difficult to diagnose, however, if all medical testing is negative it may point to pseudo seizures. Pseudo seizures are likely a manifestation of anxiety that the patient cannot control, and little is known about the causes. True pseudo seizures can have reduced occurance or go away completely with long term psychotherapy. Many sufferers do not even realize they may be suffering from anxiety at all.