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How to recognize seizure-like events that are not a seizure

Updated 02/12/2021

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 differentiate between what is and isn’t a seizure.

Events that are not seizures

Seizures are known to present a wide range of movements or behaviors that can be easy to confuse with other things. Some events look like seizures, but they may not be a seizure at all. They may be a symptom of something else or they may even be completely harmless.

Non-epileptic seizures (NES) are characterized 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 may also be a symptom of something else, or may even be completely harmless.

Here are some of the most common events that may appear similar, but are not a seizure.

  1. Fainting — One of the most common events is fainting. They are also referred to as syncope and cause a loss of consciousness and sudden involuntary movements like twitching or muscle spasms.

    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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. Transient Ischemic 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, but they’re important to diagnose quickly in case a stroke might be about to happen.

Why seeing the event is important for diagnosis

Because 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.

Furthermore, even with normal EEG and ECG tests, it can still be hard to determine exactly what happened during seizure-like events without first-hand knowledge. Knowing what happened 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 the causes of seizures can help immensely. By being able to see what happens during the events first-hand, 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 possibilities while narrowing in on the ones that are more likely.

Doctor looking at a report on a tablet

[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 recognize 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.

Video-EEG-ECG monitoring

With the combination of video, EEG, and ECG monitoring, doctors have almost everything they need for an initial diagnosis from the beginning. This kind of technology not only helps doctors in the diagnosis process, but it can also save lives. No other tool gives doctors a better understanding of seizures or seizure-like events than our video-EEG-ECG service.

To get help with diagnostics and for more tips on how to understand your events, click below to find out more.

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