Understanding Psychogenic Non-Epileptic Seizures (PNES)
Seizures that aren't caused by epilepsy but are very real — your body expressing what your mind can't.
What Are PNES?
Psychogenic Non-Epileptic Seizures (PNES) look like epileptic seizures but are not caused by abnormal electrical activity in the brain.
They are now understood to be a type of functional neurological disorder — the brain's way of expressing overwhelming distress.
PNES are involuntary and real — they are not faked, exaggerated, or 'all in your head'.
Approximately 20-30% of people referred to epilepsy centres are found to have PNES.
How PNES Differ from Epileptic Seizures
PNES may involve shaking, stiffening, falling, or loss of awareness.
Episodes tend to last longer than epileptic seizures.
They may wax and wane during an episode.
Eyes are often closed during PNES (they tend to be open in epileptic seizures).
EEG monitoring during an episode shows no abnormal electrical activity.
Anti-epileptic medications don't help with PNES.
Why They Happen
Often linked to trauma, particularly childhood abuse or neglect.
They can develop after a period of significant stress or emotional difficulty.
Sometimes triggered by a physical health scare or medical procedure.
They represent the body expressing distress that cannot be put into words.
Dissociation plays a role in many cases.
Treatment and Recovery
Accurate diagnosis is the crucial first step — PNES requires different treatment than epilepsy.
Psychotherapy, particularly trauma-focused approaches, is the primary treatment.
Learning to recognise warning signs can help manage episodes.
Stress management and emotional regulation skills are important.
Support from family and friends who understand the condition.
Recovery is possible — many people see significant improvement with appropriate treatment.