Psychogenic Nonepileptic Attacks

  • Andrea E. Cavanna


Psychogenic nonepileptic attacks are paroxysmal behavioural manifestations characterised by altered physical and/or mental function and considered to be of psychological aetiology. Unlike epileptic seizures, psychogenic nonepileptic attacks are not a manifestation of abnormal electrical activity of cortical brain areas (epileptiform discharges). Although the clinical manifestations can resemble the ones observed in epileptic seizures, it has been argued that referring to psychogenic nonepileptic attacks as ‘psychogenic nonepileptic seizures’ could be misleading. Both post-traumatic and developmental aetiological models have been proposed for psychogenic nonepileptic attacks. A previous history of trauma, including physical and/or sexual abuse, is reported in up to 80% of patients. Overall, psychogenic nonepileptic attacks are likely to result from the complex interaction between psychiatric disorders, psychosocial stressors, dysfunctional coping styles, and central nervous system vulnerability. There is increasing evidence that the process of communicating the diagnosis is important as a potentially effective therapeutic step. Management strategies for patients with psychogenic nonepileptic attacks may require psychoeducation, psychotherapy, and pharmacotherapy, as well as reduction of iatrogenic harm, achieved by discontinuing ineffective antiepileptic drugs.


Diagnosis communication Nonepileptic attacks Paroxysms Psychological aetiology Trauma 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Andrea E. Cavanna
    • 1
  1. 1.Dept of NeuropsychiatryUniversity of BirminghamBirminghamUnited Kingdom

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