Emotional trauma, the psychological response to a deeply distressing event, is strongly linked to seizure-like events. This connection is complex: trauma can directly cause physical events, or it can act as a stressor that increases the frequency of a pre-existing condition. Understanding the mechanics of these episodes clarifies how psychological distress manifests in physical symptoms resembling a neurological disorder. These seizure-like events can stem from acute stress, chronic anxiety, or post-traumatic stress disorder (PTSD), all of which can overwhelm the body’s regulatory systems.
The Difference Between Epileptic and Non-Epileptic Seizures
Seizures are broadly classified into two types: epileptic and non-epileptic. Epileptic seizures originate from an abnormal, excessive electrical discharge of neurons in the brain. This electrical surge disrupts normal communication, leading to involuntary movements, sensory changes, or loss of awareness. Epilepsy is a chronic neurological disorder characterized by two or more unprovoked seizures.
Non-epileptic seizures are physical events that resemble epileptic seizures but lack the electrical disturbance. While they can be caused by factors like heart conditions or low blood sugar, the most common type is psychogenic non-epileptic seizures (PNES), which are psychological in origin. The key difference is the source: epileptic seizures are neurological events, while PNES is a physical manifestation of psychological distress.
Psychogenic Non-Epileptic Seizures (PNES) and Trauma
Psychogenic Non-Epileptic Seizures (PNES) are physical attacks caused by psychological distress, rather than abnormal brain activity. These events are classified as a functional neurological symptom disorder, where emotional stress is converted into a physical symptom. PNES is a real, involuntary medical condition; the person does not consciously control the symptoms.
Emotional trauma is a primary cause and predisposing factor for developing PNES. Studies show a high correlation, with many PNES patients having a history of general trauma or specific experiences like physical or sexual abuse. The underlying theory suggests that overwhelming psychological distress, often related to unresolved trauma, cannot be processed normally. The nervous system, constantly on high alert, essentially “short-circuits” when faced with a trigger or overwhelming stress.
These seizure-like events are thought to be a physical way for the brain to discharge or dissociate from intolerable emotional pain or memories. The episode acts as a defense mechanism, temporarily allowing the person to split off from feelings about the distressing experience. Physical symptoms, such as shaking or loss of consciousness, are an unconscious manifestation of this stored emotional trauma.
Trauma as a Trigger for Existing Epilepsy
For individuals who already have a diagnosis of epilepsy—a pre-existing neurological condition—emotional trauma does not cause the disorder itself but significantly affects its management. In this scenario, trauma acts as an aggravator, increasing the likelihood and frequency of epileptic seizures. Acute stress, anxiety, or sleep deprivation following a traumatic event are common seizure precipitants for people with epilepsy.
The mechanism here is distinct from PNES; it involves lowering the seizure threshold. The brain has a natural threshold for electrical over-activity, and crossing this threshold causes a seizure. Psychological stress and resulting physiological changes, such as the release of stress hormones, destabilize the brain’s electrical balance, making it more excitable. This increased neuronal excitability means that a person’s brain is more vulnerable to a seizure, even from a smaller trigger. Trauma-related stress thus acts as a catalyst for a pre-existing neurological vulnerability.
Diagnosis and Management
Accurate diagnosis is critical because the management paths for PNES and epileptic seizures are completely different. The gold standard for distinguishing between the two is Video-Electroencephalography (VEEG) monitoring. This specialized test simultaneously records the patient’s brain waves (EEG) and physical behavior (video) during an episode.
If the event is an epileptic seizure, the EEG captures the characteristic abnormal electrical discharge corresponding with the physical symptoms. Conversely, if the event is PNES, the patient’s behavior resembles a seizure, but the EEG shows normal electrical brain activity throughout the episode. This finding proves the event is not neurological in origin, even though the symptoms are visually identical to an epileptic seizure.
Once PNES is confirmed, management shifts away from anti-epileptic medications, which are ineffective. Treatment focuses on addressing the underlying psychological cause, often involving a multidisciplinary team of neurologists and mental health specialists. The primary treatment is psychotherapy, particularly trauma-focused therapies like Cognitive Behavioral Therapy (CBT), which helps the patient identify triggers and develop coping strategies. For true epileptic seizures, the standard treatment remains anti-epileptic medication to control the abnormal brain electricity.