American Family Physician has an article on the curious phenomena of ‘psychogenic nonepileptic seizures’. These can look like tonic-clonic epileptic seizures; that commonly involve falling to the floor, limb shaking and unconsciousness, but are not accompanied by a disturbance in brain activity, and are thought to be related to underlying emotional issues or psychological distress.
Epilepsy is usually diagnosed with the assistance of an EEG assessment, where unusual brain activity is suggestive of the condition. A short burst of disruption (a ‘slow wave’) is show on the left, from my own epilepsy EEG.
Psychogenic nonepileptic seizures can be diagnosed when the person’s behaviour suggests a seizure, but no brain disturbance is detected.
The idea that symptoms can appear, but are produced by an underlying emotional conflict rather than the normal process of organic disorder has a long history, most associated with 19th century French neurologist Jean-Martin Charcot.
The condition was originally labelled ‘hysteria’, although is now given the less pejorative names of conversion disorder or ‘medically unexplained symptoms’.
The condition is often linked to emotional disturbance and a history of physical or sexual abuse and the presence of other psychiatric disorders. It is often considered that they are an unconcious attempt to express distress or resolve internal conflict.
Importantly, however, the symptoms are not ‘faked’, as is sometimes unkindly suggested. The person concerned typically has little or no conscious control over their symptoms or their effect, which suggests the mind and brain has a capacity for impenetrable self-deception in some cases.
Researchers are now attempting to understand how this happens, with books being published on the psychology and neuroscience of conversion disorder. Nevertheless, despite this recent work, the condition is still largely mysterious.