When people search for “PTSD seizures,” they are often referring to Psychogenic Non-Epileptic Seizures (PNES). These events physically resemble epileptic seizures but stem from psychological distress rather than abnormal electrical activity in the brain. PNES episodes are physical manifestations of overwhelming emotional states, particularly those linked to trauma and Post-Traumatic Stress Disorder (PTSD).
Understanding Psychogenic Non-Epileptic Seizures
Psychogenic Non-Epileptic Seizures (PNES) are episodes that look and feel like epileptic seizures, but are not caused by unusual electrical discharges in the brain. Instead, they are a physical expression of significant psychological distress. Researchers believe PNES symptoms result from a combination of stress impacting the body, mind, and relationships, often referred to as the biopsychosocial model.
Common characteristics of PNES include changing patterns of movement, such as flailing, stiffening, or tremors, which may appear disorganized. Individuals might experience unresponsiveness with eyes closed, or full-body shaking episodes that can last for more than 10 minutes. Some events might mimic absence seizures, involving a brief lapse in awareness, or even drop attacks. PNES often occur in response to emotional triggers or stressful situations.
Distinguishing From Epileptic Seizures
Differentiating Psychogenic Non-Epileptic Seizures (PNES) from true epileptic seizures is crucial for correct diagnosis and effective treatment. The definitive diagnostic tool is video-electroencephalogram (video-EEG) monitoring, which simultaneously records brain electrical activity and body movements during an event. This monitoring allows specialists to observe that no abnormal electrical brain activity occurs during a PNES episode, unlike during an epileptic seizure. This distinction is important because anti-seizure medications, effective for epilepsy, are not beneficial for PNES and can even cause harmful side effects.
Several observable differences can also help distinguish PNES from epileptic seizures. During a PNES event, individuals often keep their eyes closed, whereas during an epileptic seizure, eyes are typically open. Tongue biting and incontinence are less common in PNES compared to epileptic seizures. Post-ictal confusion, a period of disorientation after a seizure, is often minimal or absent following a PNES episode.
The Link Between Trauma, PTSD, and Seizures
The connection between trauma, Post-Traumatic Stress Disorder (PTSD), and Psychogenic Non-Epileptic Seizures (PNES) is well-established. Traumatic experiences, particularly childhood trauma, are highly prevalent among individuals diagnosed with PNES. Researchers propose that PNES can arise from the body’s response to overwhelming stress, where unresolved trauma or extreme emotional distress expresses itself physically when other coping mechanisms are insufficient.
One model suggests PNES acts as a defense mechanism, with seizure-like events occurring to protect an individual from the physical and emotional toll of a perceived threat, akin to a hyperaroused state. This can involve dissociative states, where the mind detaches from reality or emotions, leading to physical symptoms. The nervous system’s “fight, flight, or freeze” response, activated during trauma, can manifest as PNES, representing the body’s way of expressing what the mind cannot process or articulate.
Management and Pathways to Healing
Managing Psychogenic Non-Epileptic Seizures (PNES) primarily involves addressing underlying psychological conditions, such as Post-Traumatic Stress Disorder (PTSD). A multidisciplinary approach is often recommended, bringing together neurologists, psychiatrists, and therapists to provide comprehensive care. Since PNES is not caused by abnormal brain electrical activity, anti-seizure medications are ineffective.
Therapeutic interventions are central to recovery, with trauma-focused psychotherapies proving particularly beneficial. Cognitive Behavioral Therapy (CBT) is a widely studied approach for PNES, helping individuals manage stress and identify triggers. Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure Therapy (PE) are also effective, especially for those with co-occurring PTSD, by processing traumatic memories. Patient education about PNES, along with stress management techniques, forms an important part of the healing process.