The relationship between fear and seizure activity is complex, involving important distinctions in how the brain responds to stress. While fear itself does not directly cause epilepsy, it can influence brain activity in ways that either trigger seizures in predisposed individuals or manifest as seizure-like events of psychological origin.
The Neurological Link Between Fear and Seizure Activity
The body’s “fight or flight” response is a natural reaction to perceived threats, involving the release of stress hormones like cortisol and adrenaline. These hormones prepare the body for action and influence brain excitability.
In individuals with epilepsy, this heightened state can lower the seizure threshold, making them more susceptible to a seizure. Chronic stress has been shown to reduce the seizure threshold and increase seizure frequency in some epilepsy patients. Therefore, while fear doesn’t create epilepsy, it can act as a significant trigger for those already living with the condition.
Understanding Psychogenic Non-Epileptic Seizures
Psychogenic Non-Epileptic Seizures (PNES) are events that resemble epileptic seizures but do not involve abnormal electrical activity in the brain. They manifest as a physical response to underlying psychological distress, often linked to past trauma, anxiety, or extreme emotional states, including intense fear. These events are involuntary and are not consciously faked by the individual.
PNES can present with a wide range of symptoms, from full-body shaking similar to tonic-clonic seizures to brief losses of awareness. While the outward appearance might be similar to epileptic seizures, the core difference lies in the brain’s electrical activity; during PNES, an electroencephalogram (EEG) shows normal brain activity. PNES do not respond to anti-seizure medications, requiring psychological treatments such as cognitive behavioral therapy instead.
Underlying mental health conditions like anxiety disorders, depression, post-traumatic stress disorder (PTSD), and personality disorders are commonly associated with PNES. Studies indicate that individuals with PNES often have a higher prevalence of childhood trauma compared to those with epilepsy, suggesting a strong link between such experiences and the development of PNES.
Differentiating Seizure Types and Seeking Help
Distinguishing between epileptic seizures and PNES based solely on observation can be challenging, even for medical professionals, due to their similar outward appearances. PNES might exhibit features like longer duration, fluctuating movements, side-to-side head movements, or retained awareness during the event, which are less typical of epileptic seizures. However, no single symptom is definitive for diagnosis.
A definitive diagnosis typically requires professional evaluation by a neurologist, often involving video-EEG monitoring. This test simultaneously records brain electrical activity via EEG and captures video of the individual’s physical movements during a suspected seizure event. If the video shows seizure-like activity while the EEG displays normal brain waves, it strongly indicates PNES.
If you or someone you know experiences seizure-like events, it is important to seek prompt medical evaluation from a healthcare provider. This allows for an accurate diagnosis and the development of an appropriate treatment plan. Call for emergency medical help if a seizure lasts longer than five minutes, if another seizure quickly follows, if breathing difficulties occur, or if an injury happens.