If you find that stress triggers your seizure activity, you’re not alone. Members of MyEpilepsyTeam often talk about stress and its impact on their health. However, stress-related attacks that appear to mimic seizures may be psychogenic nonepileptic attacks (PNEAs), which are different from epilepsy. Although a PNEA technically isn’t a seizure, it’s commonly called a psychogenic nonepileptic seizure.

How Are Epileptic Seizures Different From PNEAs?

Epilepsy is a neurological disorder. A person is diagnosed with epilepsy after having two seizures that happen without any triggers and are linked to abnormal electrical activity in the brain.

A psychogenic nonepileptic attack is a functional disorder that is diagnosed after a person has episodes that may look like epileptic seizures but, in fact, are not. These attacks aren’t associated with abnormal electrical activity in the brain. PNEAs are provoked by underlying psychological distress. However, PNEA can mimic seizures, which is why it’s often mistaken for actual seizures.

Some people have a combination of both conditions, and it’s important to identify and characterize what you have because the treatment is vastly different.

“I have epilepsy and … I also have nonepileptic seizures,” one MyEpilepsyTeam member wrote. Another said, “I found out I have both generalized epilepsy and psychogenic nonepileptic events.”

Understanding PNEA

Whether brought on by a major life event or a buildup of everyday challenges, stress affects each person differently. For some, stress can lead to a PNEA, which may be misdiagnosed as an epileptic seizure. In fact, a Johns Hopkins Hospital team observed that more than 30 percent of people admitted to the hospital’s epilepsy unit for intractable seizures were experiencing psychogenic nonepileptic attacks and not epilepsy.

One key to distinguishing between PNEA and epilepsy, the Johns Hopkins team noted, was that antiseizure medications were not effective in curbing PNEA seizure-like symptoms. These drugs typically work for people with epilepsy.

Researchers have noted that in some cases, emotional stimuli can trigger epileptic seizures. Therefore, a health care team must be very detailed when evaluating people who experience symptoms so they can carefully differentiate between epilepsy and a PNEA.

If your doctor suspects you may have PNEA, they will take a detailed history, ask you and any witnesses about your attacks, and examine you. They may order an electroencephalogram (EEG) video monitoring, which is considered the best test to diagnose PNEA. This process involves monitoring a person for a set period of time via video, observing their seizure or attack activity while also analyzing their brain’s electrical activity. This can also help physicians to identify whether someone has epilepsy or PNEA.

Managing Stress

Whether you have PNEA or epilepsy, reducing the stress in your life can be helpful. According to the Epilepsy Foundation, 9 out of 10 people who actively manage their stress believe it has cut their risk of seizures.

If your health care team finds that you have PNEA and not epilepsy, your treatment is likely to involve a multidisciplinary team such as a psychologist, neurologist, primary care provider, and possibly a psychiatrist and mental health counselor to address the underlying psychological problem.

The goal will be to reduce the stressors in your life that trigger the attacks. As part of that stress-reduction strategy, you’ll also want to consider eating a healthy diet, making sure your physical health is strong, and incorporating exercise into your routine. You may want to try guided meditation.

If you instead have epilepsy, your health care team will determine which treatments will work best for you. This may include medications such as antiepileptic drugs, implanted devices, dietary changes, surgery, or a combination of these treatments — in addition to reducing your stress.

Curbing your stress can not only help clear your mind, it can allow you to get out of a loop in which you are stressed about having a seizure. “My main stress is worrying about having a seizure,” one MyEpilepsyTeam member said.

Although stress is a part of everyone’s life, managing its impact could help reduce your seizures or attacks in the future.

Talk With Others Who Understand

MyEpilepsyTeam is the social network for people with epilepsy and their loved ones. On MyEpilepsyTeam, more than 122,000 members come together to ask questions, give advice, and share their stories with others who understand life with epilepsy.

How does stress impact your life? Share your experience in the comments below, or start a conversation by posting on your Activities page.