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  • Writer's pictureChristopher Litton PsyD

The treatment of Psychogenic Non-Epileptic Seizures (PNES)

Updated: Nov 21, 2022

The first, and most important step in the treatment of Psychogenic Non-Epileptic Seizures (PNES) is an accurate diagnosis rendered by a qualified health care professional. This is done either by an epilepsy specialist (Epileptologist) or a Neurologist. The "gold standard" testing procedure is to stay overnight in a hospital, and be monitored via 24 hour video EEG (vEEG). Unfortunately, not everyone has access to a hospital with a comprehensive epilepsy program, and your Neurologist might choose to use an "at home EEG" called an "ambulatory EEG". Neurologists have also diagnosed this based on observing an episode either in office or with a video.

After the necessary data is collected, your doctor is likely to tell you something you were not expecting to hear. Specifically, your “event” was not epileptic, but rather, something related to emotional or behavioral factors. Specifically, you are told that you have suffered a psychogenic non epileptic seizure (PNES). They might goes on to explain PNES, and what causes it. In my practice, I have seen all sorts of reactions to this news, and is quite normal to be confused or upset about what you have been told.

Although PNES sounds strange, it is one manifestation of a diagnosis called a “Conversion Disorder.” This diagnosis denotes the unintentional display of physical symptoms which are unrelated to a medical problem, where the symptoms are better explained by emotional or behavioral factors. It absolutely does not mean that you are “faking it.” Research indicates that the incidence of Conversion Disorder is much higher than expected by the general public.

It is very important to remember that even though your episodes do not fit the medical definition of an epileptic seizure, they are quite real. You are not doing this on purpose, and you cannot help what is happening to you. You need special skills and tools to help you control your episodes, and no one expects you to be able to figure this out on your own. It is important for your friends and family to understand that if you could simply choose to stop, you would have made that choice long ago. No one would choose to suffer the level of agony you have been through! Just like you cannot simply “snap out of” the flu, you cannot “snap out of” PNES.

The good news is, PNES is very treatable with a type of therapy called Cognitive Behavioral Therapy (CBT). After you choose to enter treatment, you will be given a specific set of skills aimed at helping you gain control over PNES. The process begins with teaching people basic exercises that make PNES less likely to happen. It is very normal for episodes of PNES to be triggered by stressful circumstances, and various coping/stress management skills are emphasized as well.

Now it is time to start down the road to recovery, and your first step is to get in touch with a qualified mental health professional. Talk with your doctors, and they can help you locate someone who is likely to be a good match for you and your symptoms. It is difficult to guess how long this process takes, but studies have shown that many people resolve their issues in 8-12 sessions. Therapy is often covered by insurance, and you can determine your coverage by calling the number on your card.

It is very common for people diagnosed with PNES to have other mental health concerns as well. Many people struggle with Post Traumatic Stress Disorder (PTSD), and often have a very difficult life history. It is also common for people to struggle with anxiety and depression. I not only make it a priority to not only help people manage PNES, but I also make it a priority to treat any co occurring mental health concerns as well.

Both Drs. Litton and Yarbrough have years of experience in the treatment of PNES, and we look forward to being of service to you and your family!

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