Differentiation Between Epilepsy and Psychogenic Non-epileptic Seizures from the Perspective of Neurology

Psychogenic non-epileptic seizures (PNES) are characterized by abnormal movements, sensations, awareness, or cognitive changes that resemble epileptic seizures, but are caused by psychological or psychiatric factors. Although the term "PNES" is currently the most widely used and accepted, other terms, such as "functional seizures" and "dissociative seizures," are employed. According to the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders, PNES is classified as a functional neurological symptom or conversion disorder. Although the prevalence of PNES is lower than that of epilepsy, it is observed in approximately 10% and 20% of patients in epilepsy outpatient clinics and inpatient epilepsy monitoring units, respectively. Following the diagnosis of PNES, patients often face a significant burden regarding healthcare resource use, including diagnostic testing, use of anti-seizure medications, outpatient visits, and emergency room visits. Accessing appropriate treatments remains challenging. However, evidence supporting effective treatments for PNES, such as cognitive behavioral and neurobehavioral therapies, is steadily increasing.