Dissociative seizures: Causes, symptoms, and treatment

Dissociative seizures are similar to epileptic seizures in that they cause episodes of involuntary movement and behavior. However, while epileptic seizures are due to abnormal electrical signals in the brain, dissociative seizures occur for psychological reasons.

Dissociative seizures can be similar to epileptic seizures, which can result in many people being misdiagnosed initially. This can be harmful as the treatments and drugs for epilepsy will not work in people with dissociative seizures.

However, once doctors make the correct diagnosis, patients can begin psychotherapy to correct the underlying cause of the seizures. With treatment, dissociative seizures can improve significantly or go away completely.

This article describes the symptoms, causes, diagnosis, and treatment of dissociative seizures. It also offers tips on how to deal with the condition.

Dissociative seizures are a form of non-pileptic seizure caused by psychological distress. They cause episodes of involuntary movements or behaviors. In the United States, doctors refer to these seizures as psychogenic non-pileptic seizures (PNES).

During PNES, a person has dissociated, which means that they are not fully aware of themselves or are not in control of themselves. They can fall in and out of consciousness, or stop responding for a short time.

PNES can be very similar to epileptic seizures. However, PNES does not cause electrical signals to misfire in the brain. This difference is one of the main ways doctors use to differentiate the two types.

For the same reason, these seizures cannot damage the brain. A person only needs emergency treatment for a dissociative seizure if they are injured.

It is unclear how common PNES is, but 20–40% of people who need hospital monitoring for unusual seizures will get this diagnosis.

Other names for PNES are psychogenic nonpileptic episodes or pseudo-seizures. However, many people feel that the term “pseudoseizure” being older is unacceptable as it implies that the symptoms are not real, which leads to stigma.

Symptoms of PNES can vary, but often include:

• Change levels of consciousness
• trembling or pounding movements
• Pelvic thrust
• lateral shaking of the head
• brief episodes of unresponsiveness
• Screaming, crying or making other sounds
• eyes or mouth tightly closed

Yes, it is possible for both types of seizures to coexist. An older report from 2013 said that around 10% of people with PNES also have epilepsy. This common occurrence can make PNES difficult to diagnose.

However, there are some key differences between epileptic and nonpileptic seizures. For example, about 95% of dissociative seizures have their eyes closed, while most epileptic seizures have their eyes open.

Likewise, being able to speak or scream during a seizure can be a sign of PNES, as can jumping at a loud noise – neither of which is common in an epileptic seizure.

PNES appears to be an involuntary response to severe emotional distress. The symptom is heavily linked to mental illnesses such as anxiety and depression, as well as past trauma.

Psychological trauma refers to the effects that severely stressful events have on the mind. These events can include a one-time incident, such as a car accident, or multiple events that take place over a long period of time.

A history of physical or sexual abuse is one of the risk factors for PNES, which can partially explain why most of the people who experience it are women. Women are more likely to experience this type of abuse than men, especially in childhood and in intimate relationships.

Conditions associated with PNES include:

Mental health is complex and not everyone can identify a specific cause of their PNES. Even if that’s the case, the episodes are real.

Doctors can sometimes diagnose PNES based on how the symptoms differ from those of an epileptic seizure. You may be able to do this through observation or by talking to the person or family members or friends who saw the seizures.

The next step is to rule out epileptic seizures by measuring electrical activity in the brain. Doctors can do this through video electroencephalography (EEG) monitoring. In this test, an EEG monitor tests the electrical signals in the brain while a camera records a seizure. The results enable a neurologist to make a diagnosis.

To perform a video EEG test, a person may need to be in a surveillance unit or other healthcare facility.

The main treatment for PNES is psychotherapy. By talking to a psychologist or therapist, people can begin to understand the underlying cause of the seizures.

There are many forms of therapy. The best-studied form of treatment for PNES is cognitive behavioral therapy (CBT). CBT works by examining the relationships between beliefs and thoughts, emotions and behaviors.

People with a history of traumatic experience can benefit from trauma therapies, which include a range of techniques that stimulate the brain to process stressful memories and reduce their effects.

Medication can help relieve symptoms of co-existing mental illnesses and improve the quality of life. However, they will not reduce the seizures.

PNES can be disruptive, scary, or disorienting. However, while a person is undergoing treatment, there are ways to minimize these effects. The UK’s National Health Service (NHS) recommends the following coping strategies:

Sensory grounding

If a person receives warning signs of an attack, they can use sensory grounding. This involves the following steps:

1. Look for something rough or textured to carry around with you. When a seizure occurs, rub the object between your fingers and focus on how it feels.
2. Put your feet firmly on the ground and notice how firm it is.
3. Find something nearby to look at and describe yourself what it looks like, either loud or quiet.
4. Listen to the noises up close, such as B. chirping of birds or people speaking.

This strategy can prevent seizures or delay them long enough for a person to go to a private and safe place.

Abdominal breathing

Abdominal breathing can promote rest and prevent an attack. A person can do these steps:

1. Sit on your stomach with one hand, below the navel.
2. Inhale slowly through your nose and feel the belly expand.
3. Pause for 3 seconds, then exhale slowly through your nose.
4. Repeat for 20 breaths or until the warning signs of the seizure have passed.

First aid for seizures

Although psychogenic seizures are not inherently harmful, people can accidentally injure themselves. First aid for seizures includes measures to prevent this from happening.

It is helpful to let friends, family, or coworkers know what to do if a seizure occurs. You can help by:

• Remove potentially dangerous objects from the area
• move the person having the seizure to a safe place
• put something soft under your head
• speak to them calmly and reassuringly
• Do not try to restrict their movements or the sounds they make as it can be scary and potentially cause injury

If someone doesn’t get warning signs before a seizure, they may not be able to drive.

Non-pileptic seizures rarely require medical attention or an emergency call. If someone is injured, it is important to call 911 and say the seizure was not pileptic.

Identifying triggers

Some events or emotional states can trigger PNES. Realizing what these are can help someone understand how to reduce their seizures. It can be helpful to keep a journal to record when they occur and what factors may have contributed.

However, it is important not to try to avoid all of the triggers to the extent that doing so leads to isolation or prevents someone from doing the things they enjoy. In the short term, this can reduce stress or embarrassment, but in the long term it can make someone feel less productive or more overwhelmed by their condition.

A person should try to maintain a normal routine and independence whenever possible, but seek help if symptoms of PNES are causing physical or emotional difficulties.

Dissociative seizures are a type of non-pileptic seizure that many refer to as PNES. They cause episodes of involuntary movements and behaviors that occur as a result of psychological stress. The similarity of dissociative seizures to epileptic seizures means that doctors misdiagnose some people with the condition.

Treatment for PNES can reduce the frequency of seizures and reduce the impact of underlying mental illness on a person’s life. If someone thinks they have PNES, they should have a neurologist examined to confirm the diagnosis.

source https://www.bisayanews.com/2021/09/24/dissociative-seizures-causes-symptoms-and-treatment/