Research Shows Anxiety-Induced Seizures Can Resemble Epilepsy

A waiting man with hands claspedAlthough epilepsy is one of the most common causes of seizures, it’s not the only cause. Extreme emotional states can give rise to seizures. Psychogenic nonepileptic seizures (PNES) are seizures brought on by emotional states, occurring in between 2 and 33 per 100,000 people. According to one study, as many as 20% of people diagnosed with epilepsy might have PNES instead.

New research published in Epilepsy and Behavior aims to discern the differences between the two types of seizures, and researchers were able to correctly differentiate PNES from epilepsy in 83% of cases. They also found a clear connection between anxiety and seizures.

How Anxiety Triggers Seizures

Epilepsy is caused by rapid and chaotic discharge of electrical signals in the brain, but people experiencing psychogenic nonepileptic seizures don’t show this pattern. People with depression, anxiety, and similar mental health concerns can experience PNES, but doctors aren’t sure why. Strangely, a large percentage of people with PNES have epilepsy, making it even more challenging to distinguish psychologically induced seizures from those brought on by epilepsy. 

Differences between Psychogenic Nonepileptic Seizures (PNES) and Epilepsy

Differentiating between PNES and epilepsy can help people experiencing seizures get faster, more effective treatment. To evaluate differences between the two types of seizures, researchers administered questionnaires to evaluate whether and how frequently participants avoided circumstances that made them feel anxious. The group of participants included 30 people with PNES, 25 with epilepsy, and 31 with no history of seizures. Researchers found that PNES was more common among people who regularly experienced anxiety and who took steps to avoid sources of anxiety.

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Researchers also found that people who reported more somatic symptoms were more likely to experience seizures. Somatic symptoms are physical symptoms, such as headaches or vomiting, that don’t have an underlying medical cause. The study’s authors note that their research highlights the need for effective interventions among people struggling with anxiety. Because people who experience PNES tend to avoid anxiety, researchers point to the need for treatments that can help people with PNES reduce avoidance behaviors while more effectively managing anxiety.

References: 

  1. Mellers, J. D. (2005). The approach to patients with “non-epileptic seizures”. Postgraduate Medical Journal, 81(958), 498-504.
  2. New research links anxiety to seizures. (2014, August 1). Retrieved from http://www.lincoln.ac.uk/news/2014/08/932.asp
  3. The Truth about Psychogenic Nonepileptic Seizures. (n.d.). Retrieved from http://www.epilepsy.com/article/2014/3/truth-about-psychogenic-nonepileptic-seizures

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  • Kendall D

    August 5th, 2014 at 10:34 AM

    I have never heard of this. Of course I have heard of epilepsy and then regular anxiety attacks but nothing that would provoke a seizure.

  • Kristine

    August 6th, 2014 at 3:25 PM

    PNES/NEAD (Non Epileptic Attack Disorder) events are not technically “seizures”. They exhibit markedly different physical movements to the trained epileptologists, which do not correlate with the cortical map nor with any abnormal electrical discharges in the brain. A long term video EEG is the gold standard for diagnosis. The symptoms of PNES/NEAD are related to a functional disturbance (i.e. akin to severe PTSD or the aches/pains associated with depression/anxiety, etc.)

  • Lynn

    June 17th, 2015 at 1:20 AM

    I disagree Kristine. Whilst they may not be ‘epileptic’ seizures, they are seizures never-the-less! Maybe ‘convulsions’ would be a better description?

  • Lee

    August 5th, 2014 at 3:16 PM

    It would also seem plausible that the brain could show different areas of activity if the seizure is a different kind or that maybe the chemical balance of the body would be different depending on the seizure acxtivity. I could be way off base but I would just suspect that there is a lot more going on on a biochemical aspect that we can learn from and that it can go far deeper and more exoensive than just that information that a patient questionnaire might have to offer.

  • Kathleen Anne

    August 6th, 2014 at 12:29 AM

    I have had Pnes since I was about 11 yrs old I am now 48
    This article is very interesting
    I hope they do eventually come up with an effective treatment other than the treatment I have experienced of which can be sworn at, dragged out of buildings, bullied by peers not only as a child, but at the age I am now. I have also been told by staff in Hospitals that I am wasting NHS time and money.

  • Lynn

    June 17th, 2015 at 1:23 AM

    I’m so sorry you have been treated this way Kathleen 😥 I think the lack of education and awareness has a lot to do with this; what people don’t understand, they tend to fear! Xxx

  • Tyler A.

    August 6th, 2014 at 12:27 PM

    treatment the same?

  • Kristine

    August 6th, 2014 at 3:15 PM

    The treatment is not the same at all. Epileptic seizures are treated by neurologists with anti epileptic drugs, surgery, or VNS/RNS Neuro stimulators. PNES/NEAD (Non Epileptic Attack Disorder) events are treated by psychiatrists with anti anxiety medications and cognitive behavioral therapy.

  • Arlene

    August 7th, 2014 at 6:02 AM

    My 7 year old son has been taking vimpat to control both his seizures and lessen his anxiety since he was 3.

  • Colleen K

    August 6th, 2014 at 5:19 PM

    I personally have Epilepsy and have had the surgery to assist with the frequently and length of my seizures. Initially they thought I had PNES however after a number of VEEG stays I was able to prove it by having a number of GTC’s. I do suffer with anxiety and depression as a result of my Epilepsy and I can say that extreme stress/anxiety is a trigger for me. During my number of stays a number of people had been diagnosed with PNES. They were devastated. I’d never seen a seizure caused by that and they looked similar to me – until I saw my own video and understood the difference.

    One particular patient had a Code Grey called, she was extremely upset (which I understood) as her GP had put her on AED’s and the events she was having were life changing. As my Epileptologist pointed out to her, she did not want Epilepsy.

    Kathleen Anne, I’m sorry to hear about your experience and can totally relate to your devastation.

  • Vickie R

    August 6th, 2014 at 6:31 PM

    That discribes a friend of mine to a T. In 93 a friend from school(Sean) moved from another town to Berlin to go to college. He started having spells where it looked like he was having seizures. I went to the hospital with him. They told him it was anxiety. He wasn’t having seizures. They couldn’t give him anything. He ended up dropping out of school and moving back to Mass with his mom.

  • Jimmy

    August 6th, 2014 at 8:26 PM

    Hi.
    Does PNES/NEAD show itself only in “grand mal” type seizures or can it show as “petit mal” type seizures.
    Thank you
    Jimmy

  • Raoul D

    August 6th, 2014 at 10:05 PM

    Could this be why anti epileptics like dilantin cause seizures in me and the only reason I’ve been seizure free is a klonopin regemin

  • Syvanna motta

    August 20th, 2015 at 6:34 AM

    I need to find out if you have PNES if you actually have convulsions or not because I do but don’t. All my muscles tighten but I don’t jerk.

  • Rebecca

    March 28th, 2016 at 10:05 PM

    I’ve been suffering from severe anxiety and panic attacks for the last 10 years and in the spring of 2014 I started experiencing grand mal seizures and they have yet to find out why I started having them.
    I’ve wondering if my anxiety and panic attacks were the cause of my seizures, I can say experiencing the seizures have added to my anxiety as now I worry about myself to the point I don’t go anywhere without anyone. My seizures have been under control since September of 2014 with the help of Dilantin, my anxiety and panic attacks jad mostly seemed to vanish in time, my medication was later switched to lamotrigine which ever since the switch I began having anxiety and panic attacks again, and what I recognize as myclonic jerk seizures which depending on my stress level can vary in severity. Maybe someday I’ll feel like I have my life back, for now its a wait and see game. Its definitely been a complete life changer.

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