What exactly is different in the brain of an epileptic person versus the brain of a non-epileptic person?
In: 51
There is also something called PNES, psychogenic non epileptic seizures. This is commonly seen in younger women with significant history of trauma such has sexual abuse, physical abuse, molestation but can also be seen in men or anyone of any age but less commonly.
Patients who suffer from this condition have what we call “spells” which look very much like seizures, but when hooked up to a continuous brain wave monitor (continuous EEG) which is the gold standard for diagnosing seizure and record a spell, there is no electro graphic correlate to suggest it is a true epileptogenic seizure that is due to electrical misfiring. Seizure medications (anti epileptic medications) do absolutely nothing for these types of seizures. And NO, these patients are NOT faking it. It is a stress response…
For example, say you hate public speaking. Before you go up to speak, you stomach my gets sharp achy pains in it, your palms might sweat, you might stutter more. These are things that your body is doing in response to a stressor that you really don’t have much control over…when someone with PNES feels stressed, their brain will respond in very bizarre ways. Sometimes these people look like their having full blown tonic clonic seizures, sometimes they flail their extremities around, sometimes they stare off among many other presentations. If you didn’t know any better, these spells look very convincing for a true seizure.
The treatment is acceptance of the diagnosis and cognitive behavior therapy and if the patient adheres to that they generally do very well and can become spell free. You can imagine how debilitating it must be for someone. It’s not often I get to tell people what they have is treatable in the neurology world.
However, what can be dangerous about these spells is when patients present to an emergency room or whatever it may be, sometimes if the care provider doesn’t know the patient’s history, they will end up placing these patients of ventilators and blasting them with multiple seizures medications because they look so convincing for something called status epilepticus which is essentially just prolonged seizures back to back (which can be deadly because just like all your other muscles tensing up, so does you diaphragm which can lead to respiratory failure) So it’s really important to us when we diagnose someone with PNES we make it VERY clear in their chart and do a lot of patient education so they can hopefully avoid those very invasive procedures down there road.
Latest Answers