When a child falls down and their body starts jerking, most people assume that the child is having an epileptic seizure, which is caused by abnormal electrical activity in the brain. But sometimes this is not the case. Children can have events that look like seizures but actually are non-epileptic events or functional seizures.
Functional (Nonepileptic) Seizures
Functional (nonepileptic) seizures, sometimes referred to as psychogenic nonepileptic events or seizures, are episodes that are thought to arise from the nervous system feeling overwhelmed or overstimulated, much like a computer that becomes overloaded and needs to shut down and reboot. These events are real, and the child is not “faking it.” These symptoms are similar to how people might experience a headache after an overwhelming day or a stomach prior to taking an important exam.
Functional (nonepileptic) seizures are more common in teenagers but can occur in school-aged children as well. The cause or trigger for functional (nonepileptic) seizures can sometimes be difficult to know, but they are thought to be related to some combination of biological (physical body stressors like lack of sleep or illness), psychological (worried thoughts or anxiety), and social factors (such as school or peer stressors).
Managing Functional (Nonepileptic) Seizures
These seizure-like events can usually be diagnosed with a neurological evaluation that sometimes includes an EEG or other tests. Because the events are not epileptic, seizure medicines will not help. Treatment for functional (nonepileptic) seizures involves Cognitive Behavioral Therapy (CBT) to help the child learn strategies to control the events and new ways to cope with feeling overwhelmed.
When identified and treated appropriately, children can learn to control the events, and they may go away in a short time. Parents are encouraged to get their child back into school and normal activities as soon as possible.
When a functional (nonepileptic) seizure occurs, the child should move to an identified area and use CBT-based strategies to reduce the symptoms. Parents, caregivers and school staff should remain present and maintain a quiet presence without adding stimulation (would discourage talking to the child, performing sternal rubs or massaging) as this may lead to further feelings of being overstimulated and prolong the event. Parents and school personnel are also discouraged from calling 911 or taking the child to the emergency department as this also brings added stimulation that may prolong the event, and there is no medical intervention needed. With time and practice, the child can learn their warning symptoms and be able to prevent or stop events independently.
Some children can have both epileptic seizures and functional (nonepileptic) seizures and will need seizure medicine for their epilepsy. If a child has both epileptic and non-epileptic events, parents and all caregivers will need to learn how to tell the difference between the two, as the response for each type of event will be different.
Although functional (nonepileptic) seizures can be frightening and confusing for parents to witness, they are not epileptic and therefore, they are not harmful to the brain regardless of how long they may last. If you have questions or believe that your child may experience functional (nonepileptic) seizures for more information. Neurosciences Center for more information.
Dara Albert, DO, is a pediatric neurologist and epileptologist. She is the medical director of the multi-disciplinary Psychogenic Nonepileptic Events/Functional Seizure Clinic in the Pediatric Epilepsy Center at Nationwide Children's Hospital. She has a passion and scholarly interest in medical education and serves as the Associate Program Director of the Child Neurology Residency Program.
Kristen G. Trott, PhD
Psychologist
Kristen Gsanger Trott, PhD, is a psychologist in the Pediatric Psychology Program at Nationwide Children's Hospital and a Clinical Associate Professor of Pediatrics at The Ohio State University College of Medicine.
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