Non Epileptic Seizures Study: Key Findings

This non epileptic seizures study explains what researchers observed in a small retrospective comparison of people with NES and epilepsy.

Source: Frontiers in psychology

Summary

What was studied

Researchers reviewed a neurology unit's clinical database from 2022–2025 to compare non-epileptic seizures (NES) with epilepsy. NES are seizure-like episodes not explained by epileptic electrical activity during the event. The study included 38 people with NES and 23 with epilepsy without NES. Of the 38 people with NES, 18 also had epilepsy. The main comparison therefore involved 20 people with NES only and 23 with epilepsy only.

Researchers compared symptoms, examination findings, psychological or psychiatric conditions, and test results. They adjusted statistical tests for multiple comparisons. Extra analyses checked whether the main association remained when restricting the NES-only group to people with recorded video-EEG confirmation and when using a statistical model adjusted for age and sex.

What they found

Among all 38 people with NES, 94.7% had a documented psychological or psychiatric condition, including anxiety in 50.0% and depression in 28.9%. Movement-related symptoms were documented in 73.7%. Neurological examination findings were inconsistent or did not fit expected patterns in 85.7% of those who could be evaluated. Video-EEG confirmation was recorded in 73.7%.

Psychological or psychiatric conditions were more common in the NES-only group than in the epilepsy-only group: 90.0% versus 13.0%. The exact odds ratio was 50.40, with a wide 95% confidence interval of 7.29–670.28; the p-value after correction for multiple comparisons was below 0.001. Anxiety was also more common: 45.0% versus 4.3%, with a corrected p-value of 0.014. The association with psychological or psychiatric conditions remained in the extra analyses.

Broad categories of seizure symptoms did not differ significantly after correction for multiple comparisons. Among people who had MRI scans, abnormalities were found in 12 of 18 epilepsy-only patients and 0 of 10 NES-only patients, with a corrected p-value of 0.006. However, MRI testing differed between groups.

Limits of the evidence

This small, retrospective study from one neurology unit can show associations, not prove causes. Psychological or psychiatric conditions may have been assessed or documented differently between groups. The wide confidence interval means the size of that association is uncertain, despite strong statistical evidence of a difference. The abstract does not report participants' ages or explain how people were selected for MRI. Not everyone had recorded video-EEG confirmation or imaging. Test findings, including MRI results, should be treated as descriptions of this sample, not as diagnostic markers for NES. The lack of a significant difference in broad seizure symptoms does not prove the groups were identical.

For families and caregivers

The study highlights that NES and epilepsy can occur in the same person. Broad descriptions of what an episode looks like did not clearly separate the groups in this sample. Psychological or psychiatric conditions were much more common in people with NES only, but that finding alone cannot diagnose NES or show what caused the episodes.

What to watch next

Prospective studies using standardized psychiatric and seizure-symptom assessments, with separate analyses for people with NES only and those with both NES and epilepsy, are needed to clarify these findings.

Terms in this summary

Non-epileptic seizures (NES): Episodes that resemble epileptic seizures but are not explained by epileptic electrical activity during the event.
Comorbidity: Another health condition that occurs alongside the condition being studied.
Semiology: The signs and symptoms of an episode, such as movements or changes in awareness.
Video-EEG: A test that records video and the brain's electrical activity at the same time.
MRI: A scan that uses magnetic fields to create detailed pictures of the brain or other body structures.
Odds ratio: A measure comparing the odds of a finding in two groups; a value above 1 means higher odds in the first group.
95% confidence interval: A range showing uncertainty around an estimate; a wider range means less precision.
Correction for multiple comparisons: A statistical adjustment that accounts for testing many comparisons when interpreting statistical significance. This study used the Benjamini–Hochberg false-discovery-rate method.