Differentiating PNES and True Epileptic Seizures

Added: 2026-05-17

[00:00:00]Now, how do we differentiate a PNES or a pseudo seizure with a true epileptiform seizure? Now, we have previously discussed We have previously discussed many of the points. We'll just discuss that in brief. Epileptic seizure will have abnormal electrical activity. And the EEG will be normal.

[00:00:18]Epileptic seizures are brief. They have a predetermined They have a determined duration, usually 1 to 2 minutes. In fact, if any seizure gets prolonged more than 5 minutes, we call it We call it as status epilepticus. That has devastating consequences. On the other hand, in PNES, patient will continue to have abnormal movements for maybe 15 to 20 minutes. They are highly variable. They are bizarre. Can be associated with abnormal movements like pelvic thrusting. And the patient might even have retained awareness during that interval. On the other hand, epileptic seizures are usually associated with impaired awareness or loss of consciousness.

[00:01:01]Also, these events are triggered by psychological stressors. So, many of the time, there will be history of disputes within the family or some immediate stressful event.

[00:01:14]The other thing is patient who have seizures will have urinary incontinence, tongue bite, and may have injuries.

[00:01:23]PNES patient will never have injuries.

[00:01:26]Even if the patient falls, patient will not have injury.

[00:01:31]Even if the patient falls, patient will not have any significant injury if patient is having PNES. On the other hand, if the patient with atonic seizure falls, patient may have head injury.

[00:01:42]So, these are few pointers which may help you distinguish PNES or a pseudo seizure from a true epileptic >> [music]