Psychogenic Non-Epileptic Seizures (PNES) are episodes that can appear similar to epileptic seizures, involving changes in movement, sensation, or awareness. Unlike epileptic seizures, however, PNES do not stem from abnormal electrical activity in the brain. Instead, they are a manifestation of underlying psychological distress or functional neurological processes. This article explores the typical duration of these events and related aspects, including their characteristics, diagnosis, and treatment.
Understanding PNES Seizures
PNES are a type of functional neurological disorder where symptoms arise from changes in brain function, rather than structural damage or epilepsy. These episodes are involuntary and genuine, meaning individuals do not consciously control them or “fake” them. Common presentations can include convulsive movements like stiffening, jerking, or thrashing of limbs, appearing unresponsive, or displaying other seizure-like behaviors.
Instead, they are often triggered by emotional or stress-related events, such as significant life stressors or trauma. The experience of PNES is genuine and can be disruptive to an individual’s life.
How Long PNES Seizures Last
The duration of Psychogenic Non-Epileptic Seizures can vary considerably from person to person and even from episode to episode for the same individual. While epileptic seizures typically last less than two minutes, PNES episodes often persist for a longer duration. Some PNES events can last for several minutes, and in some cases, they may extend for 20 minutes or more, a phenomenon sometimes referred to as “psychogenic status epilepticus.”
Factors influencing the duration of a PNES episode can include the intensity of the individual’s psychological distress, the specific triggers involved, and the environment in which the event occurs. People experiencing PNES may report longer seizures and more negative emotions like fear both before and during the event.
Diagnosing PNES
Accurately diagnosing PNES is important to ensure individuals receive appropriate care and avoid unnecessary or harmful treatments for epilepsy. The primary method for confirming a PNES diagnosis is video-EEG (Video-Electroencephalography) monitoring. This specialized test simultaneously records brain electrical activity and captures the individual’s behavior on video during an event.
During a PNES episode, the video-EEG will show seizure-like behavior without abnormal electrical activity in the brain. This absence of epileptiform activity on the EEG differentiates PNES from epileptic seizures. A neurologist or epileptologist, a specialist in epilepsy, typically oversees this diagnostic process, analyzing both the video and EEG recordings to make a definitive diagnosis. Misdiagnosis can lead to individuals being prescribed ineffective anti-seizure medications, which carry their own set of side effects without offering any benefit for PNES.
Treatment and Long-Term Outlook
Treatment for Psychogenic Non-Epileptic Seizures primarily focuses on addressing the underlying psychological issues that contribute to their occurrence. Psychotherapy is a main approach, with Cognitive Behavioral Therapy (CBT) being the most widely studied and often recommended form. CBT helps individuals identify and modify maladaptive thoughts, emotions, and behaviors that may facilitate the development of PNES, thereby aiming to reduce their frequency.
Other psychotherapeutic approaches, such as psychodynamic therapy and mindfulness-based therapies, also play a role in managing PNES by helping individuals process emotional conflicts and improve their ability to relate to internal experiences. Managing stress and identifying personal triggers are also important components of treatment. While recovery is possible, some individuals may continue to experience seizures over time, though treatment often leads to a reduction in seizure frequency and can improve overall quality of life.