Pseudoconvulsions, or nonepileptic seizures, are behavioral events that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. They are typically due to psychological, medical, or neurological conditions, such as dissociative disorder, panic attacks, or movement disorders (Berg, 2020). Pseudoconvulsions can produce similar effects to epileptic seizures, including changes in muscle tone, jerking limb movements, and loss of consciousness. However, these behaviors are not caused by abnormal electrical activity in the brain and should not be confused with epileptic seizures.
Pseudoconvulsions are more common in children than adults, with some estimates suggesting that up to 30% of pediatric seizures may be nonepileptic in nature (Koo, Hsu, Lee, & Chen, 2017). Some of the most common causes of pseudoconvulsions in children are psychological, such as anxiety, depression, or post-traumatic stress disorder (PTSD). Medical causes, such as metabolic or endocrine disorders, cardiac arrhythmias, or drug intoxication, can also cause pseudoconvulsions in both children and adults (Berg, 2020).
Diagnosis of pseudoconvulsions is typically based on the patient’s medical history, as well as physical examination and laboratory testing. Electroencephalography (EEG) is the most commonly used tool to diagnose pseudoconvulsions, as it can detect any abnormal electrical activity in the brain (Koo et al., 2017). EEG is also useful in ruling out any other seizure types, such as epileptic seizures.
Treatment for pseudoconvulsions depends on the underlying cause. In cases where psychological factors are present, psychotherapy and pharmacological treatments, such as antidepressants and antianxiety medications, may be used (Koo et al., 2017). For medical causes, the underlying condition should be treated in order to reduce the likelihood of pseudoconvulsions.
In conclusion, pseudoconvulsions are behavioral events that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. Diagnosis is typically based on EEG and medical history, and treatment depends on the underlying cause. It is important to recognize pseudoconvulsions and understand their causes and treatments in order to ensure appropriate and effective management of these events.
References
Berg, A. (2020). Nonepileptic Seizures. In StatPearls. Treasure Island (FL): StatPearls Publishing.
Koo, B. W., Hsu, S. C., Lee, Y. H., & Chen, Y. J. (2017). Pseudoseizures: A Review. Frontiers in Neurology, 8, 596. https://doi.org/10.3389/fneur.2017.00596