“As an undergraduate student in psychology, I was taught that multiple personalities were a very rare and bizarre disorder. That is all that I was taught on ... It soon became apparent that what I had been taught was simply not true. Not only was I meeting people with multiplicity; these individuals entering my life were normal human beings with much to offer. They were simply people who had endured more than their share of pain in this life and were struggling to make sense of it.”
― Deborah Bray Haddock, The Dissociative Identity Disorder Sourcebook
Psychogenic non-epileptic seizures (PNES) are attacks that present like epileptic seizures but lack abnormal brain electrical discharges. They usually mimic tonic clonic (grand mal) seizures but may also mimic absence or complex partial seizures. They are most reliably distinguished from epileptic seizures using a video and EEG recording. It's thought that up to 25% of individuals who are diagnosed with epilepsy but who do not respond to drug therapy actually have PNES. However, the two disorders co-exist within up to 30% of patients. PNES is four times more common in females than it is in males.
Psychogenic non-epileptic seizures can be dissociative, due to conditions such as panic disorder, or factitious; of these, dissociative seizures are the most common. Dissociative seizures are a specific type of conversion disorder and so a manifestation of psychological distress. They can be the result of abuse, war, divorce, the death of a loved one, or another great loss or sudden change. The condition is slightly more common in women.
Psychogenic non-epileptic seizures have a high comorbidity rate with fibromyalgia and chronic pain. Dissociative seizures especially are associated with posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID), especially in other countries, and their prevalence in the US is rising. Treatment involves therapy, particularly eye movement desensitization and reprocessing (EMDR) for those who experienced trauma. Over half of those with PNES can eventually become seizure free, though this result might take over three years to reach. The problem lies in recognizing the cause of the individual's seizures and distress.