Seizures often misdiagnosed as epilepsy, actually stress: Study

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(CBS News) Seizures are the only visible symptom of epilepsy - but that doesn't mean all seizures indicate epilepsy, a new study shows. Many patients are admitted to hospitals for seizures that look like epilepsy but are actually triggered by stress and poor coping skills, researchers found.

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These seizures, called psychogenic non-epileptic seizures (PNES), are often found in patients such as returning war veterans, mothers in child custody battles, and overworked professionals.

For the study, published online in the journal Seizure, researchers from the Johns Hopkins Hospital looked at 40 patients with PNES, 20 with epilepsy, and 40 healthy volunteers. Participants reported their stressful life events over the past five years and the amount of stress these events induced. Each group reported roughly the same amount of stressful events, but the PNES group reported much higher levels of experienced stress associated with the events.

The results suggest people with PNES don't actually experience more stressful events than people with epilepsy or healthy people, or have actual neurological problems, researchers say - but they seem to lack effective coping mechanisms to deal with stress.

"These patients behave as if they have an organic brain disease, but they don't," study author Dr. Jason Brandt, professor of psychiatry and behavioral sciences and neurology at the Johns Hopkins University School of Medicine, said in a university written statement. "And it turns out that their life stresses weren't all that high, but they're very sensitive to stress and they don't deal with it well."

According to researchers, people with PNES are less likely to plan a course of action during stressful life events, using denial to ward off anxiety instead. Patients with PNES also tend to have other problematic behaviors and unstable relationships.

How common is PNES? A 2005 study published in the journal Neurology found that 54 percent of patients were misdiagnosed with epilepsy (through misreading of EEGS). Dr. Gregory Krauss, study author and a neurology professor at Johns Hopkins, said he is surprised by how many patients have been referred to his epilepsy unit without actually having epilepsy. Krauss says that as many as half of his patients in recent months have had pseudo-seizures.

Misdiagnosis of seizures as epilepsy is also costly, leading to unnecessary doctor visits, medications and hospitalizations in specialty units. The study highlights the need to focus more on cognitive-behavioral therapy that helps patients strengthen their coping skills.

"There's a lot of stress out there in our modern society, and this research highlights that many people don't have the skills to cope with that," said Krauss.

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