Do Psychogenic Non-Epileptic Seizures (PNES) cause neuronal damage?

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Last updated: April 20, 2025View editorial policy

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From the Guidelines

Psychogenic seizures do not cause neuronal damage, as they are psychological in origin and do not involve abnormal electrical discharges that can damage brain tissue. Unlike epileptic seizures, which can potentially cause neuronal damage due to abnormal electrical activity in the brain, psychogenic seizures are caused by psychological factors such as stress, trauma, or emotional distress rather than neurological dysfunction 1. The brain tissue remains unaffected and undamaged during psychogenic seizures because there is no abnormal electrical activity disrupting normal brain function. This distinction is important because it influences treatment approaches, which typically focus on psychological interventions such as cognitive behavioral therapy, stress management techniques, and sometimes psychiatric medications rather than anti-seizure medications.

Key Points

  • Psychogenic seizures are psychological in origin and do not involve abnormal electrical discharges
  • They do not cause neuronal damage, unlike epileptic seizures
  • Treatment approaches focus on psychological interventions rather than anti-seizure medications
  • Patients with psychogenic seizures may still experience significant distress, disability, and reduced quality of life despite the absence of neuronal damage. The most recent and highest quality study, published in 2020, supports this recommendation 1. It is essential to note that while psychogenic seizures do not cause neuronal damage, they can still have a significant impact on a patient's quality of life, and appropriate treatment and management are crucial to alleviate symptoms and improve outcomes.

From the Research

Psychogenic Seizures and Neuronal Damage

  • There is no direct evidence in the provided studies to suggest that psychogenic seizures cause neuronal damage 2, 3, 4, 5, 6.
  • The studies focus on the treatment and management of psychogenic nonepileptic seizures (PNES), as well as their diagnosis, epidemiology, and neurobiological understanding 2, 3, 4, 5.
  • Some studies discuss the comorbidities associated with PNES, such as psychiatric symptoms, social interactions, quality of life, and global functioning 3, 4, 5.
  • One study explores the relationship between seizures and the development of comorbidities, including cognition, behavior, and psychiatric disorders, but it is focused on epilepsy rather than psychogenic seizures 6.
  • Another study discusses the aetiopathogenesis of functional seizures, including possible risk factors and different aetiopathogenic models, but does not address the question of neuronal damage 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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