Pseudoseizures- new term is Psychogenic Non-Epileptic Seizures (PNES) or Non-Epileptic Attack Disoder (NEAD)
-These are episodes that are a patient’s reaction to stress. They are NOT faking these episodes and can’t control them. This doesn’t represent a patient trying to get out of jail by faking a seizure.
-To a bystander, it will look like a seizure. Best sign of a pseudoseizure- eyes closed tightly instead of wide open. Generally patients are tense instead of loose and floppy.
-Also- no post-ictal confusion with pseudoseizure- patients will wake up awake and alert immediately after pseudoseizure stops
-Patients may take years to get diagnosed. It’s important to remain non-judgmental. It may take years for them to get a proper diagnosis.
PEARL- 10-30% of patients with pseudoseizures will also have a seizure disorder diagnosed by EEG so the two can co-exist