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Guilherme Mazui

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What is the Difference Between Epileptic and Nonepileptic Seizures?

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Epileptic and non-epileptic seizures can appear similar, but they have distinct differences in their causes and treatment. Here are the main differences between the two:

  1. Causes: Epileptic seizures are caused by a disturbance in the electrical activity of the brain, while non-epileptic seizures can have various causes, such as low blood sugar, infection, electrolyte imbalance, or psychological factors like stress.
  2. Brain Activity: During an epileptic seizure, the brain experiences a surge in electrical activity, which can be detected through an electroencephalogram (EEG) test. In contrast, non-epileptic seizures do not show the same spikes in electrical activity on an EEG test.
  3. Diagnosis: To differentiate between epileptic and non-epileptic seizures, a seizure specialist may perform a video-electroencephalogram (EEG) test. Patients with epilepsy will often show characteristic spikes in electrical activity, while patients with non-epileptic seizures (NES) will show normal brain activity.
  4. Treatment: Traditional epilepsy treatments, such as anti-seizure medications, will not work for non-epileptic seizures and can even introduce harmful side effects for these patients. Instead, the treatment for non-epileptic seizures depends on the underlying cause, such as addressing the psychological factors or treating the physical condition.

It is essential to differentiate between epileptic and non-epileptic seizures to ensure accurate diagnosis and appropriate treatment. In some cases, up to 30% of adults diagnosed with epilepsy are later found to have non-epileptic seizures.

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  • What is the Difference Between Epileptic and Nonepileptic Seizures?
  • Comparative Table: Epileptic vs Nonepileptic Seizures

    • Comparative Table: Epileptic vs Nonepileptic Seizures

    Here is a table summarizing the differences between epileptic and nonepileptic seizures:

    Feature Epileptic Seizures (ES) Psychogenic Nonepileptic Seizures (PNES)
    Definition Seizures caused by excessive electrical discharges in the brain. Paroxysmal changes in behavior, motor, sensory, autonomic, cognitive, or emotional function that are not associated with an electrophysiologic abnormality.
    Diagnosis Diagnosed primarily through electroencephalogram (EEG) and video-EEG monitoring. Diagnosed based on semiological characteristics and clinical assessment, as video-EEG monitoring may not be widely available.
    Symptoms Can include loss of consciousness, muscle contractions, and involuntary movements. Symptoms are similar to ES but may lack a clear pattern or cause, and the patient may be more aware of their surroundings.
    Treatment Medications, dietary changes, and surgery, depending on the type of epilepsy. Treatment focuses on addressing the underlying psychological issues, as PNES is not caused by an electrical abnormality in the brain.
    Prevalence Accounts for approximately 90-95% of seizure cases. Accounts for approximately 5-10% of epilepsy incidence, or about 10-40% of patients with refractory seizures.

    Misdiagnosis between ES and PNES is common, and patients with PNES often experience diagnostic delays, receive inappropriate treatments, and incur increased healthcare utilization costs.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.