What should you know about pseudo seizure?

Pseudo seizure is an older, sometimes misleading term for seizure-like episodes that are not caused by the abnormal electrical activity seen in epilepsy. Clinicians may use the term functional seizures or psychogenic nonepileptic seizures instead. The movements, unresponsiveness, or altered awareness are real; the label does not mean that someone is pretending.

A first episode should not be self-diagnosed. Low blood sugar, infection, alcohol withdrawal, fainting, medication effects, and epilepsy can overlap in appearance. A clinician may ask what happened before, during, and after the event and may arrange neurological assessment or video EEG when appropriate.

Keep the person away from traffic, sharp edges, and hot surfaces. Cushion the head, loosen tight clothing around the neck, and stay calm. Do not restrain movements, put anything in the mouth, or give food, drink, or tablets until the person is fully alert. Turn the person on their side if they are not awake and are breathing normally. Note the start and end of the episode and any unusual features for the healthcare team.

After assessment, treatment may involve education, a coordinated plan, and psychological support when stress or trauma contributes. Anti-seizure medicine is not helpful for functional seizures unless epilepsy is also diagnosed; never stop prescribed medicine without medical advice.

Call emergency services if the episode is a first suspected seizure, lasts longer than expected, repeats without recovery, follows a serious injury, happens in water, or the person has trouble breathing. Seek urgent assessment for a new severe headache, fever with neck stiffness, marked confusion, or possible poisoning. These features can signal conditions such as Meningitis, Hypoglycaemia, or Alcohol Use Disorder-related withdrawal and need prompt evaluation.

Ask what diagnoses have been considered, whether an EEG or other assessment is needed, how to keep a symptom diary, and what your personal emergency plan should say. Ask before changing any medicine and discuss support for sleep, stress, anxiety, or trauma if these affect episodes.