A panic attack and a seizure are distinct medical events, though they can appear similar. A panic attack stems from intense psychological distress, while a seizure results from abnormal electrical activity in the brain. This article explores their differences and addresses whether a panic attack can lead to a seizure, including psychologically-driven seizure-like events.
Understanding Panic Attacks
A panic attack involves a sudden episode of intense fear or discomfort that often peaks within minutes. These episodes are characterized by a range of physical and psychological symptoms, representing an exaggerated “fight or flight” response. Individuals may feel a racing heart, shortness of breath, dizziness, sweating, trembling, chest pain, nausea, or tingling.
Beyond physical sensations, there can be a strong sense of impending doom, fear of losing control, or fear of dying. Panic attacks can occur unexpectedly, even in harmless situations, and while frightening, they do not cause physical harm.
Understanding Seizures
A seizure is a temporary event caused by uncontrolled, abnormal electrical activity in the brain. This electrical surge can disrupt normal brain function, leading to changes in behavior, movement, sensation, or awareness. Seizures can manifest in various ways, from involuntary muscle jerking and convulsions to staring spells or altered consciousness.
Seizures are categorized into focal seizures, originating in one brain area, and generalized seizures, involving both sides of the brain. While epilepsy is a common cause of recurrent seizures, not every seizure indicates epilepsy, as other factors like high fever or acute medical illness can provoke them.
Differentiating Between Panic Attacks and Seizure-Like Events
While panic attacks and some types of seizures can share superficial similarities, such as shaking or altered awareness, their underlying causes and characteristics differ significantly. Recognizing these distinctions is important for proper diagnosis and treatment.
Panic attacks have a rapid onset, with symptoms intensifying and peaking within 10 minutes, and subside within 10 to 20 minutes. In contrast, most epileptic seizures are much shorter, lasting only a few seconds to two or three minutes. During a panic attack, individuals remain aware of their surroundings and responsive, even if their perception is altered. Conversely, many people experiencing an epileptic seizure lose awareness or consciousness and may not recall the event.
After a panic attack, individuals often feel exhausted or drained. Following an epileptic seizure, a person may enter a post-ictal state characterized by confusion, disorientation, fatigue, or headache. Panic attacks are triggered by stress, anxiety, or specific phobias, whereas epileptic seizures are spontaneous or linked to neurological factors. While both can involve motor activity, panic attacks present with trembling or hyperventilation, while seizures involve repetitive, uncontrollable movements like rhythmic jerking or rigidity.
Psychogenic Non-Epileptic Seizures: The Connection
A panic attack does not directly cause an epileptic seizure, which is a neurologically based event. However, intense psychological distress, including severe anxiety or panic, can trigger psychogenic non-epileptic seizures (PNES). PNES are seizure-like episodes psychological in origin, not caused by abnormal electrical activity in the brain.
These episodes are considered a type of functional neurological disorder, where symptoms arise from changes in brain function without structural disease. Individuals experiencing PNES may exhibit convulsive movements, unresponsiveness, or other behaviors that closely resemble epileptic seizures, making differentiation challenging without specialized diagnostic tools like video-EEG monitoring. Unlike epileptic seizures, PNES are not associated with epileptiform activity on an electroencephalogram. PNES are genuine and involuntary, representing a physical manifestation of significant emotional or psychological stress, such as trauma. Diagnosis and treatment for PNES differ from those for epilepsy, primarily involving psychological therapies like cognitive behavioral therapy.