About 18% of children, including adolescents, with new seizures are found to have pseudoseizures (Golden et al., 1985; Pakalnis et al., 1999; Lancman et al., 2002; Lelliott & Fenwick, 1999). These events have been called non-epileptic events or episodes, non-epileptic seizures, pseudoseizures, hysterical seizures, conversion convulsions, and “fake” seizures (Gross, 1983; Gumnit & Gates, 1986; Riley & Roy, 1982; Trimble, 1981).

In conversion reactions, adults often present with a loss of function, whereas children tend to present with pain, pseudoseizures, or syncope. In children, the incidence of a conversion reaction is at least 1–2% and perhaps as high as 5% (Robins & O'Neal, 1953; Hersov, 1985; Hinman, 1958; Goodyer, 1981). Such reactions occur three times more often in adolescents than in younger children. Children often present with anxiety and psychological problems, whereas adults may present with a “la belle indifference” affect (Dubowitz & Hersov, 1976; Malony, 1980; Goodyer, 1981).

Non-epileptic seizures are one of the most common conversion symptoms in childhood. They appear in children with and without epileptic seizures. They may involve subconscious reactions to a past or present stress, or the intentional production of symptoms either to achieve a goal (Mills & Lipian, 1997; Weisbrot & Ettinger, 1998). When a child experiences both epilepsy and non-epileptic events, the parents may find the decision to seek mental health help difficult, especially if there is a history of brain injury.

Definition

Non-epileptic seizures are clinical events that resemble epileptic attacks but are not associated with physiologic CNS changes.