what are Non-Epileptic Attacks? (NEAs)

Non-epileptic attacks are similar to epileptic seizures in appearance, but they do not have the same characteristic changes in brain activity. As with epileptic seizures, people may fall and injure themselves, convulse, and may even become incontinent. No-epileptic attacks can occur for either physical or psychological reasons and diagnosis is difficult.

who has Non-Epileptic Attacks?

As with epilepsy, anyone of any age can experience a non-epileptic attack. Research suggests that it is most common in women between the ages of 15 and 25 years. It is also possible for someone who has epilepsy to experience non-epileptic attacks.

how are Non-Epileptic Attacks diagnosed?

The following methods can be used to help a specialist diagnose a ‘non-epileptic’ attack disorder:

observation

Much can be learned by observing a seizure and having a detailed description of it. Medical staff may be interested to know, for instance, in what circumstance the attack took place, duration, recovery time and behaviour during and following the seizure. No single factor will determine whether a seizure is epileptic or non-epileptic, instead it is the overall pattern of information which is most helpful.

electroencephalogram (EEG)

An EEG measures the electrical activity from the surface of the brain. A routine EEG recording takes approximately 1 hour and is completely painless. During an epileptic seizure, characteristic EEG patterns are seen. During non-epileptic attack, these EEG patterns are absent.

video telemetry

An observation of seizures can be helpful in the diagnosis of both epileptic and non-epileptic attacks. Video telemetry has been designed to enable a video recording to be taken simultaneously with the EEG.

blood test

Blood tests taken about 20 minutes after some seizures, (especially tonic clonic seizures), normally show a dramatic increase in the level of the hormone, prolactin. If the attack is non-epileptic, there may be no increase in the prolactin level.

personal history

A person’s psychological, social and medical history can also be helpful in identifying factors associated with non-epileptic attack disorder.

Are All Non-Epileptic Attacks The Same?

No. As with epileptic seizures, there are many different types of non-epileptic attacks and they include:

Panic Attacks

This type of attack can occur in response to a frightening situation and may resemble an epileptic seizure. Breathing difficulties, palpitations and even loss of consciousness can be features. These may eventually start to occur spontaneously.

‘Cut-off’ or ‘Avoidance’ Attack
This type of attack may occur when an individual is unable to cope with the emotional demands or stress of a situation. As with panic attacks, over time this may begin to happen spontaneously, as though the body has learnt an unconscious habit from which it cannot break.

A reactive Attack
This type of attack can occur as a delayed response to extreme stress and may be part of ‘Post Traumatic Stress Disorder’. Characteristics of this type of attack may include crying or screaming flashbacks. A person experiencing such an attack will have no control over their behaviour and may not remember the attack.

Manipulative Attack
This can occur in reaction to specific and unwanted situations and may be used as an attempt to control situations or people.

what should I do if someone has a Non-Epileptic Attack?

A non-epileptic attack should be treated the same as an epileptic seizure. If a person is convulsing, then cushion the head and once the attack is over, place them on their side in the recovery position.

During a non-convulsive seizure guide them away from danger and give reassurance when appropriate.

what is the treatment for Non-Epileptic Attacks?
Anti-epileptic medication will not be effective in treating non-epileptic attacks. If the attacks are thought to have a psychological cause, counselling or therapy can be beneficial and in many cases, referral to a psychologist or psychiatrist may be made.

where can i go for support?

Coming to terms with a diagnosis of non-epileptic attacks can be difficult.

Although the causes of the attacks may be different, there are many similarities between epilepsy and non-epileptic attack disorder, not least the anxiety which often accompanies a diagnosis.

Because of this and because little is generally known about non-epileptic attack disorder, support is usually best found at specialist epilepsy organisations and through epilepsy self-help groups.