POTS and Seizures: Understanding the Differences

Written and medically reviewed by Ari Magill, M.D.

Posted on September 4, 2026

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Key Takeaways

Postural orthostatic tachycardia syndrome, or POTS, is a condition that causes an unusually fast heart rate when standing up, and while it does not cause seizures, its symptoms can look a lot like epilepsy from the outside.

Postural orthostatic tachycardia syndrome, or POTS, is a condition that causes an abnormally fast heart rate when you stand up. POTS doesn’t cause seizures, and seizures don’t cause POTS. Epileptic seizures are caused by abnormal electrical activity in the brain.

But POTS and seizures can look surprisingly alike from the outside. Both can involve loss of consciousness (fainting), jerking movements, and confusion afterward. That overlap can sometimes lead to a wrong diagnosis.

If you live with epilepsy or love someone who does, understanding how POTS is different can help you notice when an episode doesn’t fit your usual seizure pattern. It can also help you have a more detailed conversation with your doctor at your next appointment.

🗳️ Have you ever fainted — lost consciousness in a way that was different from your usual seizures?

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I'm not sure.

When POTS and Seizure Symptoms Look Alike

Fainting caused by POTS can sometimes come with jerking or twitching movements, a pattern doctors call convulsive syncope. This happens in roughly 1 out of 8 people who faint, and it can look enough like a seizure to fool even trained observers.

POTS-related fainting can trigger seizure-like movements without the abnormal brain activity that defines an epileptic seizure. Instead, these movements are caused by the brain not getting enough blood flow. Similar symptoms can sometimes result in misdiagnosis.

In one case report, doctors described a woman who had convulsions that looked like seizures. When testing didn’t find evidence of epilepsy, she was misdiagnosed with a psychiatric disorder. It took years of testing before doctors traced the real cause back to POTS.

Living With POTS and Epilepsy

Some people live with POTS and epilepsy at the same time. Having both conditions can make it even harder to sort out which is responsible for a bad day.

One MyEpilepsyTeam member described it simply: “I fainted today because of my POTS, and then I had a seizure. I’m very exhausted.”

Another member shared, “My seizures are under control, but POTS has me a bit weak.”

“I fainted today because of my POTS, and then I had a seizure. I’m very exhausted.”

— A MyEpilepsyTeam member

Fatigue is one symptom both conditions share, and it can make a rough day even harder. If you’re managing both epilepsy and POTS, it may take extra patience — and a detailed symptom log — to help your doctor figure out what’s causing your fatigue.

Key Differences Between POTS and Epilepsy

When it comes to POTS syndrome and seizures, the confusion usually starts with how similar an episode can look to a bystander. Underneath, though, the two conditions are very different.

Causes

POTS happens when the part of the autonomic (automatic) nervous system, which manages heart rate and blood flow, doesn’t respond correctly when you stand up.

POTS often starts after a viral illness, pregnancy, surgery, or a head injury. It’s most common in women between the ages of 15 and 50.

Researchers haven’t pinned down one single cause, although genetics and immune system problems both seem to play a role.

On the other hand, epilepsy originates from abnormal electrical activity in the brain itself. It can follow a stroke, a brain injury, an infection, or a tumor. In many cases, doctors never identify a clear cause.

While it’s fair to ask, “Can POTS syndrome cause seizures the way epilepsy does?” The honest answer is no. The two conditions start in entirely different body systems.

Symptoms

POTS symptoms — dizziness, lightheadedness, a racing heart, brain fog, nausea — usually develop after standing and ease once you lie back down. They tend to come and go over weeks or months, often triggered by heat, standing for a long time, or getting sick.

Seizures tend to start and stop more abruptly and aren’t usually linked to posture or standing. Depending on which part of the brain is involved, they can look like a brief staring spell, a jerking movement in one limb, or a full-body convulsion.

Afterward, many people feel confused or need time to reorient, which can look similar to the fogginess that sometimes follows a POTS-related fainting spell.

Treatment

POTS treatment focuses mainly on lifestyle changes. These might include:

More salt and fluids
Compression garments
Head elevation in bed
A gradual, carefully paced return to exercise

Sometimes these measures are used alongside medication to help regulate heart rate or blood volume.

There’s currently no medication approved specifically for POTS, so treatment plans are built around each person’s individual symptoms and adjusted over time.

Epilepsy treatment centers on anti-seizure medication, which helps most people manage their condition. For those who don’t respond well to medication, other options include surgery, a specialized diet, or a nerve stimulation device.

One such option, vagus nerve stimulation, sends regular pulses to a nerve that helps calm abnormal brain activity and lessen how often seizures happen.

Because POTS and epilepsy respond to such different treatments, an accurate diagnosis matters just as much as recognizing the symptoms in the first place.

Prognosis

Most people with POTS see their symptoms ease over time, though it can take years. About 8 in 10 people eventually notice real improvement. Some people manage it well with lifestyle changes alone, while others need ongoing medical support to stay comfortable day to day.

Epilepsy’s outlook varies more widely from person to person. Many people gain full seizure control with the right medication. Others need ongoing adjustments before they find what works.

For some, epilepsy becomes very manageable over time. For others, it remains a lifelong condition that requires continual care.

Talk to Your Doctor

If you’ve had an episode that doesn’t quite fit your usual seizure pattern, or fainting that comes with jerking movements, it’s worth bringing up with your doctor. They may also want to rule out psychogenic nonepileptic seizures, another category doctors consider when episodes don’t show up on standard testing.

Two tests often help sort things out:

A tilt table test — Checks whether your heart rate and blood pressure respond abnormally when you move from lying down to standing up, which can point toward POTS.
An electroencephalogram (EEG) — Records the brain’s electrical activity to confirm whether unusual signals are behind an episode, which can point to epilepsy.

“A doctor saw me pass out and insisted it wasn’t a seizure. She said it looked like POTS.”

— A MyEpilepsyTeam member

Your doctor may also check for related factors, like changes in blood pressure, that can complicate the picture.

It can help to bring notes to your appointment. Write down when episodes happen, what you were doing beforehand, and anything a witness noticed. These might include the position you were in, how long it lasted, and how you felt afterward. Those small details often make the difference between a quick answer and months of uncertainty.

If your doctor suspects both conditions, you may see more than one specialist. POTS is often managed by a cardiologist, a neurologist, or both.

Epilepsy is managed by a neurologist. Ask each doctor you see to share notes with the other, so nothing falls through the cracks between visits.

“I’ve had bad dizziness and falls. My first neurologist referred me to a doctor who specializes in POTS, saying maybe it’s not epilepsy.”

— A MyEpilepsyTeam member

Getting the right diagnosis can take time and more than one type of testing. But it’s the first step toward the treatment that actually fits what’s going on in your body.