Question
Dear Margot,

                I am a young adult woman at the age of 21. I am hispanic, Puerto Rican. I had been to the hospital a few times a row. Stayed in for a week. They said that I have A common type is described as psychogenic seizures I dont believe them. I feel like I have complex partial seizures! I know I am going to have a seizure and then I sit and have one. My syndrome says I have seizures.

But my doctors still say: I have psychogenic (si-ko-JEN-ik), which means beginning in the mind. Psychogenic seizures are caused by subconscious mental activity, not abnormal electrical activity in the brain. Doctors consider most of them psychological in nature, but not purposely produced. Usually the person is not aware that the spells are not "epileptic." The term "pseudoseizures" has also been used (mostly in the past) to refer to these events.

But I dont have it I know for sure they did a EEG on me twice didnt find nothing I said that is odd. I get seizures and I feel pain in my temporal lobe and frontal lobe of the brain I need help no one believes me. But my mom aunt nancy and grandparents that is it. Oh and my priest. So I always ask my mom what happend she said you dont remember. I said no. I was blank! Twice in my LIFE I my mom going by what she said saw my eyes roll back and just blanked out like a stare. And ever since I dont know what happened after that. I get tired after two of them and I sleep. I have something else to share Here's a typical story:

"Harold's spells begin with a warning; he says he's going to have a seizure Seizure A sudden, excessive discharge of nervous-system electrical activity that usually causes a change in behavior.Closeand usually sits down. If I ask him how he feels, he just says 'I feel it.' Then he makes a funny face, a mixture of surprise and distress. During the seizure he may look at me when I call his name but he never answers. He just stares and makes odd mouth movements, as if he's tasting something. Sometimes he'll grab the arm of the chair and squeeze it. He may also pull at his shirt as though he's picking lint off of it. After a few minutes, when he's coming out of it, he asks a lot of questions. He never remembers his 'warning' or these questions. The seizures make him tired; if he has two in the same day, he often goes to sleep after the second one."

And another story: "Susan's seizures usually occur while she's asleep. She makes a grunting sound, as if she's clearing her throat. Then she'll sit up in bed, open her eyes, and stare. She may clasp her hands together. If I ask her what she's doing, she doesn't answer. After a minute or so, she lies down and goes back to sleep." So see what I mean this is what I go through. And the doctors say I go through this: The Pseudoseizures most often imitate complex partial or tonic-clonic (grand mal) Grand mal
An older term for a tonic-clonic seizure.Close seizures. Family members report episodes in which the patient stiffens and jerks. Doctors rarely witness the actual event, so they are drawn toward the diagnosis of epilepsy. Often years can be spent trying to treat the spells as epileptic seizures without success. Doctors have identified certain kinds of movements and other patterns that seem to be more common in psychogenic nonepileptic seizures than in seizures caused by epilepsy.But I told my docotors thousands of times I dont have psychogenic seizures! I feel a real seizure and I get pain in my head. And then I just get into a daydream like state and just start jerking voilent my mom says. I need help someone to listen to me for once. So Morgot CAN YOU HELP ME PLEASE!  

Answer
Hi Jacqueline and thanks for writing,

Differentiating Seizures can be difficult as most doctors do not witness the actual seizure events. Psychogenic nonepileptic seizures (PNES), or pseudoseizures are paroxysmal episodes that resemble and often misdiagnosed as epileptic seizures. Paroxysmal nonepileptic episodes can be either organic or psychogenic. Syncope, migraine, and transient ischemic attacks (TIAs) are examples of organic, nonepileptic paroxysmal symptoms.

PNES are common at epilepsy centers, where they are seen in 20-30% of patients referred for refractory seizures. PNES are probably also common in the general population, with an estimated prevalence of 2-33 cases per 100,000 population, which makes PNES nearly as prevalent as multiple sclerosis or trigeminal neuralgia.

Because of its low sensitivity, routine EEG is not helpful in confirming a diagnosis of PNES. Ambulatory EEG is increasingly used, it is cost effective, and it can contribute to the diagnosis by recording the habitual episode and documenting the absence of EEG changes. EEG video monitoring is the criterion standard for diagnosis and indicated in all patients who have frequent seizures despite taking medications. With an experienced epileptologist, combined electroclinical analysis of both the clinical semiology of the ictus and the ictal EEG findings allows for a definitive diagnosis in nearly all cases. If an episode is recorded, the diagnosis is usually easy, and PNES can usually be differentiated from epilepsy.

I hope this information helps - perhaps you could ask your doctor to do EEG video monitoring if they haven't already to help get to a certain and accurate diagnosis.

Wishing you all the best,

Margot

Excerpts from: http://www.emedicine.com/neuro/topic403.htm