Psychogenic Non-Epileptic Seizures
PNES are seizure-like events triggered by psychological factors, not epilepsy, but still require care and safety.
Psychogenic Non-Epileptic Seizures (PNES) are seizure-like episodes that resemble epileptic seizures but are not caused by abnormal electrical activity in the brain. Instead, they are often associated with psychological, emotional, or stress-related factors. PNES are sometimes called non-epileptic attack disorder (NEAD) and can be part of a complex mental health condition.
During PNES, a person may experience movements, behaviours, or unresponsiveness similar to epileptic seizures, including shaking, stiffening, or altered awareness. However, there are key differences: PNES often present with eyes closed during the episode, may have irregular or fluctuating patterns, and typically do not include the postictal confusion (recovery period) seen in epileptic seizures.
In first aid, the approach is similar to that for epileptic seizures—focus on safety, reassurance, and monitoring. Move hazards away, cushion the head if needed, and stay with the person until the episode passes. Avoid restraining their movements and do not attempt to force anything into their mouth.
If this is the person’s first seizure-like episode, the cause is unclear, or they are injured, call 000 for medical assessment. For people with a known diagnosis of PNES, episodes may resolve more quickly if they are spoken to calmly and reassured.
Although PNES are not caused by epilepsy, they are real medical events that require understanding and support. Proper medical evaluation is essential to confirm the diagnosis and guide long-term management.
Jerking or shaking movements
Altered awareness or unresponsiveness
Eyes often closed during the event
Irregular or varying seizure patterns
Rapid recovery without post-seizure confusion
Keep the person safe from injury during the episode.
Do not restrain their movements.
Stay calm and offer reassurance.
Monitor breathing and responsiveness.
Seek medical advice if the cause is unknown or if injury occurs.
Psychogenic Non-Epileptic Seizures (PNES) are seizure-like episodes not caused by abnormal electrical activity in the brain. They are often linked to psychological or emotional factors and can look similar to epileptic seizures.