Psychogenic Nonepileptic Seizures versus pseudoseizure

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After reading a lot of comments showing a lack of knowledge on thos topic and personally experiencing even fellow ICU nurses assume these are the same, I find it imperative to have the nursing community realize the difference between pseudo seizure and Psychogenic Nonepileptic Seizures. One is a sub clinical diagnosis for underlying somatoform disorder from psychological trauma ect, that creates a non epileptic seizure appearing like a seizure but actually having no impact on the electrical activity of the brain.

A pseudoseizure is not epilepsy. It is a generalized term for any seizure being caused from a source other than epilepsy. Rather it be hypoglycemia, overdose, or unknown origin. Please dont treat the patients as "fakers". Even if and only if the neurologist gives a diagnosis of somatoform seizures, please have compassion and patience for this very very real and troubling experience the patient is going through. To assume you know why and what is going on with a patients complex neurological system that is difficult for even skilled neurologists to detect is beyond your scope of practice and as I have seen changes the quality of care and compassion provided for the patient. Just a little side note. I know a lot of nurses are aware of this detail amd there are many who are even more skilled than I, but please know that we are nurses, with the purpose of caring and protecting our patients mentally and psychologically as much as we are able..

We are not here to judge and definitely not capable of determining what neurological process is going on in a person. Even epileptic patients sometimes have odd symptoms and no eeg activity found yet... doesn't mean a thing. If seizure meds start helping the reoccurence of seizures in an atypical or partial complex seizure patient that is a pretty good clue tht it's epilepsy but it doesn't give a 100 percent definitive answer even to the neurologist. Listen to docs. And love your patients especially if they have such a troubled past that they create a protective method for emotional trauma.

I hope I have taught some people and not offended as many. But I'm sure there will be both responses.. as there usually is in life.

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Specializes in Critical Care.

I would agree nurses often unfairly judge some sufferers of psychogenic nonepileptic seizures (PNES) due to a lack of knowledge, but they aren't different from "pseudoseizures".

Pseudoseizure is just an older name for psychogenic nonepileptic seizures.

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1 hour ago, amethystJsmn said:

After reading a lot of comments showing a lack of knowledge on thos topic and personally experiencing even fellow ICU nurses assume these are the same, I find it imperative to have the nursing community realize the difference between pseudo seizure and Psychogenic Nonepileptic Seizures. One is a sub clinical diagnosis for underlying somatoform disorder from psychological trauma ect, that creates a non epileptic seizure appearing like a seizure but actually having no impact on the electrical activity of the brain.

A pseudoseizure is not epilepsy. It is a generalized term for any seizure being caused from a source other than epilepsy. Rather it be hypoglycemia, overdose, or unknown origin. Please dont treat the patients as "fakers". Even if and only if the neurologist gives a diagnosis of somatoform seizures, please have compassion and patience for this very very real and troubling experience the patient is going through. To assume you know why and what is going on with a patients complex neurological system that is difficult for even skilled neurologists to detect is beyond your scope of practice and as I have seen changes the quality of care and compassion provided for the patient. Just a little side note. I know a lot of nurses are aware of this detail amd there are many who are even more skilled than I, but please know that we are nurses, with the purpose of caring and protecting our patients mentally and psychologically as much as we are able..

We are not here to judge and definitely not capable of determining what neurological process is going on in a person. Even epileptic patients sometimes have odd symptoms and no eeg activity found yet... doesn't mean a thing. If seizure meds start helping the reoccurence of seizures in an atypical or partial complex seizure patient that is a pretty good clue tht it's epilepsy but it doesn't give a 100 percent definitive answer even to the neurologist. Listen to docs. And love your patients especially if they have such a troubled past that they create a protective method for emotional trauma.

I hope I have taught some people and not offended as many. But I'm sure there will be both responses.. as there usually is in life.

I am not sure you have this right.

Pretty sure diabetic seizures, or febrile seizures, or brain trauma seizures are not pseudoseizures.

And, I am also pretty sure that if somebody stops seizing briefly to tell you they are having a seizure, and what medication helps, it could be called either pseudoseizure or PNES.

I do think that you are right, that PNES, AKA pseudoseizures, is part of a greater clinical picture that can be hard to understand, and that all PTs deserve compassion. But, I don't follow your distinction between the two terms.

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This is good reading on the subject.

https://www.ncbi.nlm.nih.gov/books/NBK441871/

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