Frequency of key symptoms and signs in PNES vs ES
| PNES | ES | |
|---|---|---|
| Etiology | Psychic | Organic |
| Interictal EEG | Normal | Normal/with epileptiform abnormalities |
| Seizure length | Usually > 2 minutes | Usually < 2 minutes |
| Onset | Often gradual | Usually sudden |
| EEG patterns are only in wakefulness | Some patients describe altered sensations for a long time before the episode | |
| Wakefulness/sleep | ||
| Frequency | Variable | Parossistic/in cluster |
| Triggers (light, noise) | Occasionally | Rarely |
| Aura | Variable | Variable |
| Seizures’ place | Mostly at home | Everywhere |
| Witnesses | Yes | Variable |
| Seizures’ pattern | Variable | Stereotyped |
| Rolling motor activity | Common | Very rare |
| Asyncronous movements of limbs | Common | Rare |
| Finalized movements | Occasional | Very rare |
| Rhythmic pelvic movements | Occasional | Rare |
| Opisthotonus, (“arc de circle”) | Occasional | Very rare |
| Side to side movements | Common | Rare |
| Tongue biting (tip) | Occasional | Rare |
| Tongue biting (sides) | Rare | Common |
| Prolonged ictal atonia | Occasional | Very rare |
| Shout | Ictal phase (with dramatic, mystic or obscene content) with crying and sobs Occasional | At the big inning, with grunts, along with clonic movements |
| Mouth closure in tonic phase | Occasional | Very rare |
| Eyelid closure | Very common | Rare |
| Resistance to eyelid opening | Very common | Rare |
| Babinski sign | Negative | Positive if convulsions are present |
| Pupil reflex to light stimuli | Maintained | Usually absent |
| Reactivity while unconscious | Occasional | Very rare |
| Cianosis | Usually absent | Usually present |
| Post-ictal confusion | Rare | Common |
| Seizure induction | Triggering | None |
| Postictal stupor | Rare | Frequent |
| Urine or feces loss | Reported (more rarely) | Reported |
| Postictal amnesia | Variable | Usual |
| Seizure remembering under hypnosis | Yes | No |
| Effect of hypnosis | High | Mean |
| Injuries | Rare | Minor, frequent |