Epileptic seizures are transient events of altered neurological function that occur because of paroxysmal brain electrical activity. Other events of altered neurological function may look very much like seizures, but are not caused by electrical brain activity. Epileptic seizure-like events may be caused by changes in blood pressure, heart rate and rhythm, or by changes in blood sugar. Emotional triggers may also cause transient epileptic seizure-like events. Stress, depression, and anxiety may cause physical symptoms that closely resemble seizures. In fact, it may not be possible for a physician to tell the difference between an emotionally triggered seizure – called a psychogenic seizure – and an epileptic seizure unless an electroencephalogram (EEG) can be recorded during the event. The EEG shows brain electrical activity and will differentiate epileptic and nonepileptic seizures.

Dr Steven Schachter is Associate Professor of Neurology at Harvard Medical School and an epileptologist at Beth Israel Deaconess Medical Center. He is Chair of the Professional Advisory Board of the Epilepsy Foundation.

In this chapter, Dr Schachter deals with nonepileptic seizures, drawing from his knowledge of the field and his own personal experience caring for individuals with this condition. Diagnosis may be difficult, but is especially important in order to ensure that the right kind of treatment is provided.