Australia
Updated 31/01/2024
Until a diagnosis is made, some doctors may refer to your seizures as “events”. Many events can cause unusual behaviours that may look like a seizure. A seizure with a loss of consciousness or fainting because of low blood sugar can look similar to an observer.
For doctors trying to diagnose seizures, this can present a challenge, especially if they were unable to see the event first-hand. It’s only by studying the electrical activity in the brain during an event that a doctor can definitively differentiate between what is and isn’t a seizure.
Misdiagnosing events as seizures can lead to incorrect treatments such as being prescribed anti-seizure medication and serious life-style changes like being told not to drive. It’s important to speak with your doctor to get a confident diagnosis of your events.
Events that are not seizures
Seizures can present as a wide range of movements or behaviours that can be easy to confuse with other things. Some events look like seizures but they may not be a seizure at all.
Non-epileptic attack disorder (NEAD) is characterised by events that resemble epileptic seizures but are not caused by epileptic activity in the brain. Some non-epileptic events are thought to have a psychological basis.
The seizure-like-event may also be a symptom of something else, or may even be completely harmless.
Here are some of the most common events that may mimic seizures:
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Fainting — One of the most common events is fainting. This is also referred to as syncope and causes a loss of consciousness. Sometimes sudden involuntary movements like twitching or muscle spasms are also associated.
When people have involuntary movements after fainting, it’s called convulsive syncope, which may look very similar to a seizure but is actually a common symptom of fainting.
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Migraines —Like fainting, migraines are very common and may share many of the same symptoms of a seizure. Some migraines can include things like loss of consciousness, confusion, numbness, paralysis, sensitivity to light and sound, mood swings, and hallucinations.
All of these symptoms can easily be confused as seizures, as they can all cause unpredictable movements and behaviours.
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Movement disorders — Tics, tremors, and other involuntary movements can look like a myoclonic seizure or focal seizure, but they may be caused by things like Tourette’s syndrome, Parkinson’s disorder, Huntington’s disease, and other disorders that affect the brain.
These types of disorders will not change electrical levels in the brain, but the sudden movements they cause can look similar to seizures at first glance.
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Panic/anxiety attacks —Among other things, panic attacks can cause confusion, the sense that surroundings aren’t real, dizziness, sweating, and feeling out of control. It’s also common for people to feel strong feelings that something bad will happen and other signs of intense fear.
When experiencing a panic attack, it’s often difficult to tell or explain what’s happening, which can lead to confusion with seizures or other events like heart attacks.
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Sleep disorders — Many kinds of sleep disorders can cause seizure-like symptoms. For example, night terrors and sleepwalking may cause unpredictable movements that look like seizures but may be caused by dreams.
Other disorders like narcolepsy may cause someone to fall asleep suddenly, making it appear as though they’ve suddenly lost consciousness. Lack of sleep can also lead to symptoms such as sudden sleep, hallucinations, or confusion which may be confused with seizure symptoms.
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Transient Ischaemic Attacks (TIA) — These events are similar to strokes and are also sometimes known to be a warning sign of strokes. Blood supply to certain parts of the brain is cut off for a limited time, which is what causes seizure-like symptoms. These include tingling sensations, numbness, sensory changes, and weakness. TIAs usually last longer than seizures, and they’re important to diagnose quickly to limit the chances of stroke occuring.
- Functional neurological disorder (FND) — A group of symptoms such non-responsiveness, sensory symptoms and atypical movements. The cause could be due to the presence of an underlying neurological condition, but cannot be explained by disease or anatomical abnormalities. Often the Cause of FND is found to be psychological.
Why seeing the event is important for diagnosis
Since there are so many seizure-like events that can be confused with actual seizures, diagnosing them accurately can be difficult. Not only are there many seizure-like events, but there are also more than 40 types of epilepsy and many more non-epileptic seizures. Non-epileptic seizures are usually caused by mental stress or physical conditions.
As EEG and ECG tests, only record electrical activity in real time, it can be hard to tell what was happening in the brian at the time of an event. Therefore, it can still be hard to determine exactly what happened during seizure-like events without firsthand knowledge. Knowing what happened clinically during the event is one of the best advantages a doctor can have. That’s why video documentation is such a powerful tool when it comes to diagnosing seizures.
Having a professional who understands seizures can help immensely. By being able to see what happens during the events, doctors can form a much more accurate diagnosis than they could with EEG or ECG alone. Watching the specific kinds of movements and behaviours while they happen allows them to dismiss many differential diagnoses while narrowing in on the ones that are more likely.
This is especially helpful when dealing with issues that need to be diagnosed quickly, as doctors will have more information to use right away.
It’s also extremely useful for diagnosing events that may have similar EEG results as seizures but that are caused by something else. To a doctor who’s trained to recognise seizures, it’s much easier to know what they’re dealing with when the evidence is right in front of them rather than hearing descriptions secondhand or from test results alone.
[Image description: A doctor wearing a stethoscope is looking at something displayed on a tablet.]
This is especially helpful when dealing with issues that need to be diagnosed quickly, as doctors will have more information to use right away.
It’s also extremely useful for diagnosing events that may have similar EEG results as seizures but that are caused by something else. To a doctor who’s trained to recognise seizures, it’s much easier to know what they’re dealing with when the evidence is right in front of them rather than hearing descriptions second-hand or from test results alone.
Utilising video-EEG-ECG monitoring for diagnosis
With the combination of video, EEG, and ECG monitoring, doctors have almost everything they need for an initial diagnosis from the beginning. This technology is extremely helpful to doctors in the diagnosis process. No other tool gives doctors a better understanding of seizures or seizure-like events than our video-EEG-ECG service.
Before you see a doctor about your events, it will be useful to keep an eye out for symptoms that can help your doctor differentiate between epileptic and non-epileptic events.
Here are key indicators to look out for:
- Duration — Epileptic seizures typically only last from a few seconds to a few minutes. Non-epileptic events often last longer than epileptic events, and can sometimes last several minutes or hours.
- Inconsistency — Most epileptic seizures have rhythmic, repetitive patterns. Non-epileptic events will lack rhythmic or repetitive actions and behaviour of body parts.
- Emotional triggers — Non-epileptic events may be triggered by emotional stressors or psychological factors
- Witness descriptions — It’s important to get detailed accounts from witnesses and make note of events that only tend to happen around specific people or groups of people
Despite their challenging nature, non-epileptic seizures are treatable, often by addressing underlying psychological factors.
We’re here to help
Events can come in many forms, and it’s important to tell the difference between epileptic and non-epileptic events. There are common events that look like seizures but aren’t, and when symptoms overlap, video-EEG-ECG monitoring can help your doctor understand what is happening. If you or a loved one is experiencing events, keep an eye on how long they last, if they’re consistent, and what the triggers are. To learn more about monitoring services, reach out to us here. We’re here to support you on your journey, click below to find out more.
