Psychogenic non-epileptic events are behavioral episodes that look like real epileptic seizures. They are not caused by electrical problems in the brain, like epileptic seizures. Non-epileptic events are serious. They are not life-threatening. They cannot hurt your child’s brain. These are real events, usually caused by stress. It is important to remember that your child is not faking the event.
Some children who have epileptic seizures can also have non-epileptic events. Talk to your child’s neurologist about the differences between the two. You will need to deal with each one differently.
Causes of Psychogenic Non-Epileptic Events
Psychogenic non-epileptic events can be caused by a trauma that has not been dealt with or by stress over time. Some examples of a traumatic event or stress that may cause a non-epileptic event are:
- Bullying (Picture 1)
- Death in the family
- Problems with school or sports
- Problems with friends or family
Early Warning Signs
Your child may have signs or symptoms that he or she is about to have a non-epileptic event. Some of these may be:
- Changes in breathing
- A tight feeling in the chest
- Shaking arms, legs, or body (tremors)
How it is Diagnosed
Psychogenic non-epileptic events are diagnosed with:
- An electroencephalogram (said like: e LEK tro en SEF ah lo gram). This is also called an EEG (please see HH-III-5 EEG). For the EEG, many small round buttons (called electrodes) are put on your child’s head. Wires attached to the buttons go to a computer that records electrical activity from the brain. These recordings will tell the doctor if there is any unusual activity during the test. The doctors and nurses will watch the event on the EEG while it is happening, if they can.
An epileptic seizure is caused by unusual brain activity. If there is no unusual activity, then it is probably a non-epileptic event caused by stress.
If no events happen during an EEG, then the events can sometimes be diagnosed if we can see a video recording of the events or hear you describe them. There can be other causes for abnormal movements, like tics, fainting, and movement disorders. We can usually decide if this is the case when we see the movements or hear you describe them.
- A psychological exam is also important in diagnosing these events. It may help the doctor figure out the stress in the child’s life that is causing the events.
- Counseling with a therapist is the main treatment for psychogenic non-epileptic events.
- The goals of treatment are to:
- Learn the early-warning signs.
- Stop the non-epileptic events from happening again.
- Find the things that cause the events. These things are known as triggers.
- Learn how to better manage stress.
- Your child may also be referred to a psychiatrist or your primary care provider. This doctor may recommend depression or anxiety medicines for your child. Seizure medicines will not work because the events are not seizures caused by epilepsy.
- Sometimes we cannot decide if an event is an epileptic seizure or a non-epileptic event. If this happens, treatment may be started for both.
How to Respond to a Non-Epileptic Event
If your child has been diagnosed with non-epileptic events by a doctor, you will need to know how to help when one happens.
- If you can, move your child to a quiet area, like a bedroom or the school nurse’s office.
- Take away anything that is distracting to your child. Turn off the TV. Have other people leave the room.
- Have your child breathe deeply to calm down. He should slowly breathe in through the nose to a count of 5. Have your child slowly breathe out through the mouth to a count of 7.
- Do not give your child extra attention, like talking to him during an event. The event will be over faster if the room stays quiet.
- Only call the emergency squad or go to the hospital if the event is very different from your child’s usual non-epileptic event and it is not stopping.
Going to School
- If your child has not been going to school because of the events, it is important that he or she goes back as soon as possible.
- The doctor’s office will give the school staff information about the non-epileptic events so they can help your child the right way.
- School staff needs to respond to the events the same way you do. It is very important that you tell your child’s teachers and school nurse the early warning signs and the best ways to treat the event. These may be different for every child.
Get more information and treatment help at the Psychogenic Non-Epileptic Event Clinic. If you have any questions about this information or need to schedule an appointment, call the clinic at 614-722-4625.
HH-I-370 10/14 Copyright 2014, Nationwide Children’s Hospital