Acronym in French of Crises Non Epileptiques Psychogènes

Incidence estimated at 2-30/100,000.  Most frequent in young adults (15-35 years) of female gender; described in children from 8 years of age.  Critical events resembling epileptic seizures, but without the characteristic electrical discharges associated with epilepsy. They fall into the category of the functional neurological disorders, also known as conversion disorders (formerly hysteria). A more recent term to define these events is non-epileptic dissociative seizures.

Contributing factors are:         a history of sexual or physical abuse is found in 33 % of patients; strong emotion (unexpected death); intrafamilial or interpersonal conflicts; true epilepsy coexists in 22 % of cases; severe migraines; a few cases appeared after general anesthesia.

Diagnosis:         video-EEG, absence of rise in blood prolactin levels in the 20 minutes following the event.

Treatment:         cognitive-behavioural therapy, treatment of true epilepsy or associated psychiatric disorders

Anesthetic implications: 

Information of the nursing staff to avoid unnecessary antiepileptic treatment. If associated with epilepsy, provide objective evidence to differentiate it from psychogenic seizures. Risk probably increased before induction, on awakening and in the post-anesthetic period.

References : 

-        Lichter I, Goldstein LH, Toone BK, Mellers JD.
Nonepileptic seizures following general anesthetics: a report of five cases.
Epilepsy Behav 2004;5:1005-13.

-        Verstraete A, Bodart O.
Les crises non épileptiques psychogènes.
Rev Med Liège 2023; 78 : 273-80.

Updated: January 2024