Clinical distinction of dissociative non-epileptic seizures (“pseudoseizures”) from epileptic seizures
Dissociative non-epileptic seizures (“pseudoseizures”) | Epileptic seizures | |
Induced by anger, panic, suggestion | Common | Rare |
Onset | Often gradual | Usually sudden |
Duration | Often prolonged, occasionally hours | 1–3 minutes |
Breathing and colour | Breathing continues, stays pink | Usually apnoeic and cyanosed |
Retained consciousness | Common | Uncommon |
Pelvic thrusting, back arching, erratic movements | Common | Rare |
Fighting, held down, may injure others | Common | Rare |
Eyes closed | Common | Less common |
Resisting eye opening and eye contact | Common | Rare |
Occur only in company | Common | Rare |
Lateral tongue bite | Rare (minor) | Common |
Self injury | Rare | Common (occasionally serious) |
Incontinence | Rare (occasionally with experience) | Common |
Post-ictal confusion | Rare | Common |