Pseudoseizures are a physical manifestation of an emotional disturbance. They resemble epileptic seizures, but, unlike the seizures caused by epilepsy, they are not caused by electrical disruptions in the brain. People experiencing pseudoseizures often experience loss of consciousness, grand mal-like twitching or jerking, and aggravated emotional states. These episodes may last for 20 minutes or more.
Physicians believe that pseudoseizures are psychological defense mechanisms, and may be brought on by episodes of severe stress or emotional trauma. The seizures tend to occur when patients try to suppress the trauma, often taking the person suffering with them by surprise, as do epileptic seizures.
The difference between epileptic seizures and pseudoseizures can be difficult to recognize, even for trained medical professionals. The physical appearances of epileptic seizures and pseudoseizures are virtually identical. Generally, a diagnosis of pseudoseizures is reached after a complete neurological work up is performed, thorough seizure history and description is obtained, and the results of an electroencephalogram (EEG) are analyzed to gauge differences in the brain's electrical activity from what would be expected of someone prone to epileptic seizures.
One of the most common complications involved in the diagnosis and treatment of pseudoseizures is the misconception that people who suffer from the phenomena are hypochondriacs, hysterics, or "faking it." The name for the condition alone, "pseudoseizures," leads some people to think of the occurrences as medically suspect.
Many patients who experience pseudoseizures are urged to seek counseling. This can be a good or bad therapeutic option, depending on the context. As pseudoseizures are a physical manifestation of intense emotional or
psychological stress, or a physical response to a childhood trauma, counseling to work through the underlying cause of the pseudoseizures is certainly an important step toward resolving the concern. However, counseling alone will not resolve the pseudoseizures. The physical manifestation of the disorder will not resolve if the entirety of the phenomena is not considered and treated.
Most importantly, it is crucial that patients and healthcare providers remember that pseudoseizures are seizures. There is a complete lack of control inherent in any seizure activity, and the potential ramifications of that loss of control can be just as devastating for people suffering from pseudoseizures as it can for those living with epileptic seizures. Doctors are split as to whether or not driving restrictions should be placed on people who suffer from pseudoseizures. However, where the onset of an attack of either is unpredictable, it is important to consider what safety precautions should be put into place to protect people who experience pseudoseizures, and to protect those around them.
Treatment of Pseudoseizures
Although physical in nature, pseudoseizures are coping mechanisms of the psyche of the person afflicted. Similar to multiple personality disorder, the psychological disturbances of a person suffering from pseudoseizures can become so overwhelming to the system that they manifest themselves physically. Pseudoseizures are medical occurrences.
If a patient has already been prescribed anticonvulsant medications, they should be discontinued (under a doctor's supervision), as they may actually exacerbate the condition. Anti-anxiety medications may be prescribed, with the addition of psychiatric services. It is important to address the root of the psychological stressors that are causing the emergence of the pseudoseizures, but they should be addressed as a part of the whole picture, and not as the whole picture.
Ideally, with the help of anti-anxiety medication and counseling, the disorder can begin to be brought under control. People suffering from pseudoseizures often have a long journey toward recovery, a journey that often includes medication, psychiatric counseling, and close medical supervision. It can be long and frustrating. However, with proper intervention, people do find themselves in full recovery from the condition.