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What Are Psychological Conditions That Mimic Seizures?

Learn about psychological conditions that mimic seizures from Steve Wolf, MD and Patty McGoldrick, NP in this Howcast video.


There are many things that can mimic seizures that can be confusing to us neurologists. We know of things like reflux, little babies that get, their gastric juices get up and tickle their throat can create jerking or funny movements that can look like seizures. Babies who can have breath holding spells where they cry and go into that silent cry, and they can jerk and twitch. But, it's not being a seizure. And then there are ones that are psychological. There are ones that often kids will come in and the family is saying that they're staring and zoning out. And the teachers are noticing this at school. And the child is worked up for having absence seizures, and it actually turns out that they're just distracted or they have a learning disability and that they're having difficulty understanding the material that's being presented. The bigger group of psychological seizures, or things that mimic seizures, are pseudoseizures. Which are episodes that really look like seizures, but they may have some giveaway that the eyes are closed during the seizure or their eyes are open. They may do certain pelvic thrusting that you don't normally see during an epileptic seizure. And the way to figure this out is by videotaping them, doing an overnight video EEG where you can capture these events and determine if they're really epileptic or if they're pseudoseizures. So, pseudoseizures are deep seeded psychological problems that manifest themselves as seizures. There are other psychological things that can cause stuff that looks like a medical problem. But, pseudoseizures don't mean that they're faking it. They're real. They're unconscious. Subconscious. It's a subconscious feeling that comes up. So, what's important is us doctors not to say when someone has a pseudoseizure that it's just nothing and to ignore it. You need to get to the root of the problem and find out what's going on. Because these are real things happening to the patient and if you don't get to the bottom of that problem you're not going to stop these things from happening. They're seizures, they're just not epilepsy. They're not coming from the brain, but it's your body's reaction to this terrible amount of stress that's going on. So, psychological things that look like seizures can be pseudoseizures, they can be staring spells. And then in babies there are other events that are medical that look like seizures as well. And a way to figure out whether they're seizures or not, is to do a video EEG to see the event and to capture it and make sure that there's no correlation with abnormalities on the EEG of the brain.

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