Have nonepileptic seizures/psychogenic nonepileptic seizures (PNES)?

Posted by DrivenByME @drivenbyme, Nov 9, 2017

In January 2014, after a battery of tests, I was diagnosed with psychogenic non epileptic seizures (PNES.) Information was not as plentiful as the resources are now, yet what I did find offered no real hope of recovery. November 2017 I am 2 years seizure-free. I am hope to all who decide they ARE going to recover from PNES. I've made YouTube help guides for those searching (youtube.com/christinemauriello) I hope you find guidance you need, when you need it.
Please feel free to use this forum for anything related to PNES.
God bless

Interested in more discussions like this? Go to the Epilepsy & Seizures Support Group.

Profile picture for meagan @meagan

I was born premature at 25 weeks born with epilepsy. Been on keppra for 23 years but my neurologist says that I have non epileptic seizures along with a second neurologist’s opinion which said I have PNES seizures and took me off my seizure medication but my primary care doctor put me back on my seizure medication and it has been helping with my seizures, during my seizure my eyes are open and roll back into my head but my MRI CTSCAN VIDEO EEG LAB WORK comes back normal along with everything coming back normal I have a neurological condition called neurofibromatosis type 1 and MRI of the brain come back normal then in march I had a partial hysterectomy but still having seizures every now and then but my aura is elevated heart rate before the seizure but during the seizure heart rate is normal along with oxygen level but my blood pressure goes up also I have Mitral valve prolapse. I’m just wondering on what to do next cause neurologist wants to take me off the liquid keppra by slowly decreasing.

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I recently had an episode that several doctors said was a seizure but no one could put a name to it. I stopped walking an couldn't or wouldn't move. EMTs laid me down and an ambulance took me to the hospital. I became unconscious for 2 1/2 days, was intubated. My temperature went up to 103.4 degrees and my blood glucose rose to 614 mg/dl. Had many tests, EEG, MRI, CT scan, spinal tap, blood work. Nobody could tell me why this happened. Any ideas?

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Profile picture for tonyde @tonyde

I'm getting a little nervous about it, everything from not having a seizure to having a really bad seizure. No seizure and it's a worthless hospital stay, a cardiac related seizure may not show brain activity and a bad seizure may cause permanent damage. I need the 5-dy EEG to help me find the cause and gain better control. The reality is anyone could have a seizure not related to brain activity or permanent damage from a seizure without being hospitalized for an EEG. I just have more time to worry about it.

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Hi @tonyde
I completely understand your nervousness. I felt the same way when I had a 3-day EEG at the hospital for exactly the reasons you mentioned.
Try to remember that you'll be in the safest possible environment at the hospital. If a seizure does happen, you'll have immediate medical care available.
Have you been able to discuss these specific concerns about the 5-day EEG with your neurologist? Sometimes talking through the "what ifs" with your doctor can provide reassurance.
Chris

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Profile picture for Chris Gautier, Volunteer Mentor @santosha

@tonyde Hi
Your question about blood pressure and seizures is really important, especially given your cardiac history.
From my understanding, both scenarios you mentioned are possible. High blood pressure can potentially trigger seizures in some people, and seizures can also cause blood pressure to spike during and after the event.
Your question reminds me of someone's story. She had a cardiac arrest alongside a seizure at home. Doctors haven't been able to determine what came first, that is: whether the cardiac arrest triggered the seizure or vice versa.
How are you feeling about the upcoming EEG? I remember you starting a discussion about 5-day EEGs in the hospital in our group last June.
Chris

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I'm getting a little nervous about it, everything from not having a seizure to having a really bad seizure. No seizure and it's a worthless hospital stay, a cardiac related seizure may not show brain activity and a bad seizure may cause permanent damage. I need the 5-dy EEG to help me find the cause and gain better control. The reality is anyone could have a seizure not related to brain activity or permanent damage from a seizure without being hospitalized for an EEG. I just have more time to worry about it.

REPLY
Profile picture for tonyde @tonyde

I've started taking Keppra extended release about 8 weeks ago and it's helping. I do have a question on non-epileptic seizures. I had a seizure in a hospital and my blood pressure skyrocketed to the level where they called in the stroke team. I have no memory of the seizure.

My question is could my blood pressure suddenly increase for some unknown reason and cause the seizure or did the seizure cause my blood pressure to skyrocket. Unfortuntely, my brain activity wasn't being recorded so I have no idea if it was abnormal.

I ask because I'm scheduled for a five-day in-hospital EEG and my blood pressure going high enough to cause a stroke is a real concern. I do have a stent in my "widow maker" artery and that only increases my concern.

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@tonyde Hi
Your question about blood pressure and seizures is really important, especially given your cardiac history.
From my understanding, both scenarios you mentioned are possible. High blood pressure can potentially trigger seizures in some people, and seizures can also cause blood pressure to spike during and after the event.
Your question reminds me of someone's story. She had a cardiac arrest alongside a seizure at home. Doctors haven't been able to determine what came first, that is: whether the cardiac arrest triggered the seizure or vice versa.
How are you feeling about the upcoming EEG? I remember you starting a discussion about 5-day EEGs in the hospital in our group last June.
Chris

REPLY
Profile picture for meagan @meagan

I was born premature at 25 weeks born with epilepsy. Been on keppra for 23 years but my neurologist says that I have non epileptic seizures along with a second neurologist’s opinion which said I have PNES seizures and took me off my seizure medication but my primary care doctor put me back on my seizure medication and it has been helping with my seizures, during my seizure my eyes are open and roll back into my head but my MRI CTSCAN VIDEO EEG LAB WORK comes back normal along with everything coming back normal I have a neurological condition called neurofibromatosis type 1 and MRI of the brain come back normal then in march I had a partial hysterectomy but still having seizures every now and then but my aura is elevated heart rate before the seizure but during the seizure heart rate is normal along with oxygen level but my blood pressure goes up also I have Mitral valve prolapse. I’m just wondering on what to do next cause neurologist wants to take me off the liquid keppra by slowly decreasing.

Jump to this post

I've started taking Keppra extended release about 8 weeks ago and it's helping. I do have a question on non-epileptic seizures. I had a seizure in a hospital and my blood pressure skyrocketed to the level where they called in the stroke team. I have no memory of the seizure.

My question is could my blood pressure suddenly increase for some unknown reason and cause the seizure or did the seizure cause my blood pressure to skyrocket. Unfortuntely, my brain activity wasn't being recorded so I have no idea if it was abnormal.

I ask because I'm scheduled for a five-day in-hospital EEG and my blood pressure going high enough to cause a stroke is a real concern. I do have a stent in my "widow maker" artery and that only increases my concern.

REPLY
Profile picture for gregd1956 @gregd1956

Dear @meagan
All young life is great; alive! All of us has problems: born, accidents, sickness, shooting, falling down, and on. Some serious; some not.

Your life gives you a place that helps yourself and helping to others. I had a bicycle accident from 2012. I Lise my memory and knowing and under standing and doing. No more driving; no more swimming; no more understanding my doctors, little or no reading or my drugs-meds. Live lost my job, that I loved, the City at Newport News, Va. Thankfully, my wife, Karen, helps me, daily.

I became a Brain-Injury member 2012. Now, I take 3 times a day of for ant- seizure. My doctor took me the last 4 years that ‘stopped” my seivure (sp?).

I pray for you and the rest people within this place for you and your (the word, is not here) ❤️

Thx,
Greg D. @greg1956

PS; I believe Christ inside me; daily this mement!

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My neurologist gave me a good idea to help with my reading skills. He suggested I read the first sentence of the paragraph, then skip to the last sentence if I found the article interesting. That gave me a good overview without complicating my thought process. I could always go back and read the entire paragraph if I felt it was needed, which wasn't too often.

It helped me concentrate, reduced my frustration and encouraged me to read more. It took years but that along with other brain exercises made a major improvement in the quality of my thinking.

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Profile picture for meagan @meagan

I was born premature at 25 weeks born with epilepsy. Been on keppra for 23 years but my neurologist says that I have non epileptic seizures along with a second neurologist’s opinion which said I have PNES seizures and took me off my seizure medication but my primary care doctor put me back on my seizure medication and it has been helping with my seizures, during my seizure my eyes are open and roll back into my head but my MRI CTSCAN VIDEO EEG LAB WORK comes back normal along with everything coming back normal I have a neurological condition called neurofibromatosis type 1 and MRI of the brain come back normal then in march I had a partial hysterectomy but still having seizures every now and then but my aura is elevated heart rate before the seizure but during the seizure heart rate is normal along with oxygen level but my blood pressure goes up also I have Mitral valve prolapse. I’m just wondering on what to do next cause neurologist wants to take me off the liquid keppra by slowly decreasing.

Jump to this post

Dear @meagan
All young life is great; alive! All of us has problems: born, accidents, sickness, shooting, falling down, and on. Some serious; some not.

Your life gives you a place that helps yourself and helping to others. I had a bicycle accident from 2012. I Lise my memory and knowing and under standing and doing. No more driving; no more swimming; no more understanding my doctors, little or no reading or my drugs-meds. Live lost my job, that I loved, the City at Newport News, Va. Thankfully, my wife, Karen, helps me, daily.

I became a Brain-Injury member 2012. Now, I take 3 times a day of for ant- seizure. My doctor took me the last 4 years that ‘stopped” my seivure (sp?).

I pray for you and the rest people within this place for you and your (the word, is not here) ❤️

Thx,
Greg D. @greg1956

PS; I believe Christ inside me; daily this mement!

REPLY
Profile picture for voiperhana @voiperhana

Hi. First time poster, long time lurker.I had my first seizure in March, now another last saturday. I`m 43 years old, never had any seizures in my life before this.There is no epilepsy in my family as far as I was able to research and ask my relatives. I also had an EEG, MRI`s, CT-scan, X-rays taken and blood tests, all came out clean and everything was fine in the scans.My therapist thinks this is related to my ptsd - most likely c-ptsd, but it´s not yet a diagnose where I`m from. Meaning that it´s a difficult case of ptsd that requires treatment, psychotherapy and medication. I`m on Tramadol, Pregabalin and Xanax, the medication has been same for 8 years now with no problems whatsoever. With the meds and therapy I have been able to stabilize my life and get some control to the symptoms, all in all my life has gotten better and easier. And now, out of nowhere I get seizures with absolutely no reason other than ptsd.So my question is, are there others with this kind of violent symptoms of ptsd? If so, what has helped you? I would be grateful for any tips or advice, I would just want to live my life and try to make it better day by day, so I could enjoy life for once, perhaps try to get a part time job and a relationship and so forth.Thank you, have a good one and stay safe out there.

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Hi @voiperhana
Thank you for sharing your story and welcome to our group!
Dealing with seizures, either from PNES (Psychogenic Non-Epileptic Seizures) or epilepsy, is challenging.
While my seizures are related to epilepsy, I've learned a bit about PNES through our group discussions, including a recent thread that might be helpful to you:
Epilepsy or PNES seizures?
https://connect.mayoclinic.org/discussion/epilepsy-or-pnes-seizures/
What you're describing - seizures with clean neurological tests but a strong connection to PTSD/C-PTSD - sounds more consistent with PNES. These seizures can look very similar to epileptic ones but aren't caused by abnormal electrical brain activity, which could explain why your EEG, MRI, and other tests came back normal.
If you're comfortable sharing, could you tell us more about what your seizures looked like? Details about movements, duration, or any warning signs you noticed might help others in the group who have similar experiences share what's worked for them.
Chris

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Profile picture for meagan @meagan

I was born premature at 25 weeks born with epilepsy. Been on keppra for 23 years but my neurologist says that I have non epileptic seizures along with a second neurologist’s opinion which said I have PNES seizures and took me off my seizure medication but my primary care doctor put me back on my seizure medication and it has been helping with my seizures, during my seizure my eyes are open and roll back into my head but my MRI CTSCAN VIDEO EEG LAB WORK comes back normal along with everything coming back normal I have a neurological condition called neurofibromatosis type 1 and MRI of the brain come back normal then in march I had a partial hysterectomy but still having seizures every now and then but my aura is elevated heart rate before the seizure but during the seizure heart rate is normal along with oxygen level but my blood pressure goes up also I have Mitral valve prolapse. I’m just wondering on what to do next cause neurologist wants to take me off the liquid keppra by slowly decreasing.

Jump to this post

Hi. First time poster, long time lurker.I had my first seizure in March, now another last saturday. I`m 43 years old, never had any seizures in my life before this.There is no epilepsy in my family as far as I was able to research and ask my relatives. I also had an EEG, MRI`s, CT-scan, X-rays taken and blood tests, all came out clean and everything was fine in the scans.My therapist thinks this is related to my ptsd - most likely c-ptsd, but it´s not yet a diagnose where I`m from. Meaning that it´s a difficult case of ptsd that requires treatment, psychotherapy and medication. I`m on Tramadol, Pregabalin and Xanax, the medication has been same for 8 years now with no problems whatsoever. With the meds and therapy I have been able to stabilize my life and get some control to the symptoms, all in all my life has gotten better and easier. And now, out of nowhere I get seizures with absolutely no reason other than ptsd.So my question is, are there others with this kind of violent symptoms of ptsd? If so, what has helped you? I would be grateful for any tips or advice, I would just want to live my life and try to make it better day by day, so I could enjoy life for once, perhaps try to get a part time job and a relationship and so forth.Thank you, have a good one and stay safe out there.

REPLY
Profile picture for Jake @jakedduck1

@mpost1234

You stated, “the legs it’s more of a pretzel, but still just so tight and tense nothing can break it until the body releases it.” It's important to remember that you should never hold or restrict seizure movements or force limbs into any position. Seizure contractions can be extremely powerful and potentially lead to broken bones. If your husband is experiencing tonic-clonic seizures, he shouldn't experience pain during the seizure itself since he should be unconscious. However, if he is feeling pain as he begins to regain consciousness during the postictal phase that's understandable.

Just because an EEG does not show electrical abnormalities doesn’t mean your husband isn't having epileptic seizures. In fact, around 50% of individuals with active epilepsy can have normal EEG readings. The most accurate way to diagnose PNES is through video EEG monitoring in an Epilepsy Monitoring Unit (EMU). You can find various EMUs across the US at the following link: https://naec-epilepsy.org/find-a-center.

Here are a few distinctions between epileptic seizures and psychogenic episodes:

1. Epileptic seizures are caused by abnormal electrical activity, while PNES episodes are psychologically induced.
2. Typically, patients with epilepsy have their eyes open during a seizure; in contrast, those having psychogenic episodes usually have their eyes closed.
3. Most epileptic seizures are shorter compared to psychogenic episodes, which tend to last longer.
4. Patients experiencing psychogenic seizures often deal with negative emotions before and during the episode, finding it challenging to process their feelings, which can lead to crying.
5. Epileptic seizures lasting 5 minutes or more are classified as Status Epilepticus and demand immediate medical attention; this is not applicable to PNES.
6. The shaking movements in epileptic seizures are generally synchronous, whereas psychogenic episodes often lack this synchronization.

It's entirely possible for individuals to experience both epileptic and psychogenic seizures. Have you noticed a reduction in seizure activity since your husband started taking Keppra?

My best wishes to both of you.
Jake

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@mpost1234 Welcome to Mayo Clinic Connect!

@jakedduck1 has a lifetime of experience and knowledge of seizures and how they affect one's life. I have little doubt his informative response will help you understand your situation.
Ginger

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