NES are paroxysmal disruptive changes in a persons behavior that resemble epileptic seizures but are not associated with the characteristic electrophysiologic brain changes of epilepsy. NES are also referred to as pseudoseizures and, like epilepsy, they have no single cause. NES and epileptic seizures have similar observable manifestations, presenting with alterations in behavior, consciousness, or convulsions; no single clinical feature reliably distinguishes epileptic seizures from NES. NES must be distinguished from physiologic nonepileptic events (eg, febrile seizures, convulsive syncope secondary to cardiac arrhythmias, migraine variants, posttraumatic brain injury seizure, substance-induced seizures). Children may have nonepileptic paroxysmal behaviors, including mannerisms, staring spells, parasomnias, hyperventilation attacks, breath-holding spells, syncope, and movement disorders. These behaviors are seen in younger children with normal results on an electroencephalogram (EEG) and do not require psychiatric intervention for resolution.
- Psychogenic nonepileptic seizures (NES).
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