When a Seizure Isn’t Epilepsy

When a child falls down and starts jerking their body, most people assume that the child is having an epileptic seizure, which is caused by abnormal electrical activity in the brain. But sometimes this is not the case. Children can have events that look like seizures but actually are non-epileptic events.

“Events” that can be confused for epileptic seizures include breath-holding spells, fainting, movement disorders, sleep disorders and even migraine headaches. In addition, most people are surprised to learn that stress can cause a child to have an episode that looks like an epileptic seizure.

Stress and Non-Epileptic Seizures
Just as stress can cause children to have headaches and stomachaches, stress can also cause events that look like seizures, called psychogenic non-epileptic events. They are called psychogenic because they are caused by stress.

Sometimes they may be referred to as pseudoseizures, but this can be a misleading term. These events are a real response to stress and the child is not “faking it.” They are more common in teenagers but can occur in school-aged children as well. Sometimes children show no other signs of stress, and parents have a hard time understanding why this could be happening. Difficulties with school work, friends and family or an event that the child views as traumatic can be the source of stress.

Managing Non-Epileptic Episodes
These seizure-like events can usually be diagnosed with an EEG and a psychological evaluation. Because the events are not epileptic, seizure medicines will not help. Treatment for stress-caused non-epileptic events involves counseling to help the child learn strategies to control the events and new ways to cope with stress.

If identified early, children can learn to control the events and they may go away in a short time. Parents are encouraged to get their child back into school and normal activities as soon as possible. When a non-epileptic event occurs, parents should not call 911 or take the child to the emergency department. This only causes further stress for the child. The child needs to learn how to prevent or come out of the event on his own.

However, some children have both epileptic seizures and non-epileptic events and will need seizure medicine. If a child has both epileptic and non-epileptic events, parents will need to learn how to tell the difference between the two, as the response for each type of event will be different .

Although stress-induced, non-epileptic events can be frightening and confusing for parents, the good news is that they are not epileptic. In most cases, the child does not need to take seizure medicine and can learn to control the events with time. If you have questions or believe that your child may experience stress-related non-epileptic events, speak to your pediatrician or visit the Neurosciences Center  for more information.

Debbie Terry, NP
Debbie Terry, RN, MSN, CNP is a Pediatric Nurse Practitioner in the Division of Pediatric Neurology at Nationwide Children’s Hospital. Her clinical and research interests are in pediatric epilepsy with a focus on parent/family education, ketogenic diet and psychogenic non epileptic seizures. Debbie has traveled to Nicaragua on mission trips to provide education to parents of children with epilepsy.

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