Epileptic seizures are defined as a sudden change in perception or behavior associated with an electrical discharge that synchronizes the nerve cells in the surface of the brain. Patients with epileptic seizures frequently have abnormal electrical markers for a risk of seizures on electroencephalograms (EEG). But not all behaviors that resemble seizures are actually epileptic. Some people may demonstrate brief convulsive movements when they faint, raising the suspicion of seizure activity. The most common causes are seizures that are not epileptic are emotional stress, conflicts and traumatic psychological experiences. Psychogenic non-epileptic seizures (PNES) are frequently associated with unresponsiveness or even convulsive activity, symptoms which are typically exhibited by epileptic seizures.

PNES are very commonly misdiagnosed as epilepsy. PNES are common, 10-40 percent of patients referred to epilepsy centers have PNES. The most reliable test to make the diagnosis is video-EEG monitoring. Patients are commonly admitted to an epilepsy monitoring unit, where they are taken off seizure medications, and monitored with simultaneous video and EEG recording. PNES are diagnosed when seizures are recorded without any change of the EEG activity. PNES can be diagnosed with nearly 100 percent reliability by video-EEG monitoring.

It is important to emphasize that PNES are disabling, and that people with PNES are not pretending or faking the symptoms. Frequently patients with PNES have others psychiatric co-morbidities, most commonly mood and anxiety disorders. The most important intervention is a psychiatric evaluation in order to assess the need for psychotherapy or medical treatment. Early diagnosis of PNES is critical to avoid delays in treatment and exposure to unnecessary medications with serious negative side effects. With the appropriate treatment, the PNES can resolve.