Connect with others who understand.

sign up log in
Resources
About MyEpilepsyTeam
Powered By

Dissociative Events Explained

Posted on March 03, 2022
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Brooke Dulka, Ph.D.

Dissociative events — sometimes known as “dissociative seizures” — are not epileptic seizures. Rather, they are somatic manifestations (physical reactions) to psychological stress. Other terms used for dissociative events include “psychogenic nonepileptic seizures,” “psychogenic seizures,” or “functional seizures.” Some scientists have previously used the word “pseudoseizures” to describe this type of event, but the use of this term is now discouraged because they are, in fact, a real phenomenon.

Dissociative events are challenging for clinicians to diagnose and treat because, on the surface, they look so similar to epileptic seizures. Understanding dissociative events is vital not only for doctors and specialists but also for the individuals experiencing them.

Who Has Dissociative Events?

Between two and 33 people per 100,000 experience dissociative events. Roughly 75 percent of people with dissociative events are female, according to a 2017 study published in Seizure. These events most frequently start during late adolescence or early adulthood. Another study found that dissociative events were common in females of all ages, while the proportion of males increased with age.

Having preexisting mental health disorders is one of the biggest risk factors for developing dissociative events. Common mental health conditions that can come before psychogenic nonepileptic attacks include:

  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Dissociative disorders
  • Borderline personality disorder

Dissociative events are also associated with a history of trauma and sexual abuse. One study found that this was especially true when the trauma occurred during childhood or adolescence. People with epilepsy can experience both epileptic and nonepileptic seizures.

Research also shows that dissociative events can run in families. This suggests a genetic component to this type of occurrence; however, more research is needed to confirm this.

Diagnosing Dissociative Events vs. Seizures

Dissociative events can be difficult to diagnose because they are frequently mistaken for seizures typically associated with epilepsy. On the surface, they may look the same: A person having a dissociative event may display abnormal movements, changes to their senses, or loss of awareness. The person has no control over what is happening.

One way a medical professional can tell the difference between dissociative events and epilepsy is by using an electroencephalogram (EEG) to record electrical activity in the brain. A doctor may also conduct blood tests and brain scans to rule out other diseases.

When a person has an epileptic seizure, the EEG will usually show abnormal electrical activity in the brain. However, when someone is having a dissociative (or nonepileptic) event, the EEG will not show abnormal electrical activity.

Although video EEG monitoring is the most reliable way to come to a diagnosis, it’s important to understand the psychological factors that may be contributing to dissociative events. Thus, diagnosing dissociative events often requires a team of doctors including neurologists, psychiatrists, and psychologists.

Treating Dissociative Events

Approximately 20 percent of people with dissociative events attempt suicide within 18 months of receiving a diagnosis. Therefore, it is important to begin treatment as soon as possible after diagnosis. Antiepileptic drugs will not improve dissociative events.

One large clinical trial showed that behavioral therapies can improve dissociative events, either on their own or in combination with an antidepressant. People in this study with dissociative events who attended psychotherapy — specifically cognitive behavioral therapy (CBT) — had a 51.4 percent drop in dissociative events and experienced significant improvement in depression, anxiety, quality of life, and overall functioning.

This same study showed that those individuals who combined CBT and the antidepressant drug Zoloft (sertraline) showed a 59.3 percent event reduction. They also improved in overall functioning. However, medication alone did not show a reduction in events.

All in all, dissociative events are caused by psychiatric and physical factors. Therefore, they should be treated by a team that includes a neurologist (for diagnosis), a psychiatrist (for medication management), and a psychologist (for CBT).

When witnessing someone experiencing a dissociative event, you should employ the same first-aid techniques as you would for an epileptic seizure:

  • Remain calm.
  • Ensure the person is in a safe place, positioned on their side.
  • Do not restrain them or put anything in their mouth.
  • Stay with them until the event is over.
  • Video recording the event may be helpful for doctors to assist in diagnosis and treatment.

Building a Community

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

Do you or a loved one experience dissociative events? Share your experience in the comments below, or start a conversation by posting on MyEpilepsyTeam.

All updates must be accompanied by text or a picture.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Brooke Dulka, Ph.D. is a freelance science writer and editor. She received her doctoral training in biological psychology at the University of Tennessee. Learn more about her here.

Related articles

One in every 20,000 to 40,000 children has Dravet syndrome.Dravet syndrome seizures are hard to c...

What Is Dravet Syndrome? Understanding Symptoms, Treatments, and More

One in every 20,000 to 40,000 children has Dravet syndrome.Dravet syndrome seizures are hard to c...
Lennox-Gastaut syndrome (LGS) is a severe type of epilepsy that causes seizures that typically be...

Lennox-Gastaut Syndrome: Symptoms, Causes, and Treatments

Lennox-Gastaut syndrome (LGS) is a severe type of epilepsy that causes seizures that typically be...
Tuberous sclerosis complex (TSC) is a rare genetic disorder that causes benign tumors and lesions...

Tuberous Sclerosis Complex: Life Expectancy, Skin Pictures, and More

Tuberous sclerosis complex (TSC) is a rare genetic disorder that causes benign tumors and lesions...
Although epileptic seizures can occur randomly and without warning, many people find that their s...

10 Common Seizure Triggers and 9 Tips To Avoid Them

Although epileptic seizures can occur randomly and without warning, many people find that their s...
The U.S. Food and Drug Administration (FDA) has approved updated boosters for messenger RNA (mRN...

New COVID-19 Vaccine Boosters for Omicron: What To Know if You Have Epilepsy

The U.S. Food and Drug Administration (FDA) has approved updated boosters for messenger RNA (mRN...
Epilepsy is one of the most common neurological disorders in the world. There are more than 50 m...

Photosensitive Epilepsy: Symptoms, Causes, and Treatment

Epilepsy is one of the most common neurological disorders in the world. There are more than 50 m...

Recent articles

The ketogenic diet involves consuming high-fat, low-carbohydrate foods like avocados, healthy oil...

The Ketogenic Diet and Epilepsy: Does It Help Prevent Seizures?

The ketogenic diet involves consuming high-fat, low-carbohydrate foods like avocados, healthy oil...
Cannabidiol (CBD) is a derivative of hemp that can be used to treat severe forms of epilepsy in c...

Which Types of Epilepsy Can Be Treated With CBD?

Cannabidiol (CBD) is a derivative of hemp that can be used to treat severe forms of epilepsy in c...
Genetics contribute greatly to some types of epilepsy but not all types.Most children born to par...

Is Epilepsy Genetic? The Chances of Inheriting Epilepsy

Genetics contribute greatly to some types of epilepsy but not all types.Most children born to par...
A child living with severe epilepsy may experience one or more types of seizures, some of which a...

What Do Severe Childhood Seizures Look Like?

A child living with severe epilepsy may experience one or more types of seizures, some of which a...
The road to a diagnosis isn’t always smooth for people with symptoms of severe epilepsy. A thorou...

5 Types of Tests for Severe Epilepsy

The road to a diagnosis isn’t always smooth for people with symptoms of severe epilepsy. A thorou...
If you witness someone having a full-body seizure, try to ensure they are lying down on their si...

What To Do During a Seizure: Your Epilepsy Questions Answered

If you witness someone having a full-body seizure, try to ensure they are lying down on their si...
MyEpilepsyTeam My epilepsy Team

Thank you for subscribing!

Become a member to get even more:

sign up for free

close