How is it Diagnosed?

Dissociative Seizures
NHS GGC

Dissociative Seizures are diagnosed by a doctor (commonly a Neurologist) who takes a detailed history of the episodes.

Doctors will inquire about the type of episodes and may get a history from both you and people who have seen them (family, friends, colleagues).

Sometimes, a diagnosis of Dissociative Seizures can be made without further investigations. A detailed description of the dissociative seizures can be enough for a doctor to recognize it.

Doctors who make this diagnosis are highly qualified and have trained for many years to be able to tell the difference between dissociative seizures and epileptic seizures.

If needed, doctors may carry out different tests. The tests may include:

  • A brain wave test (called an EEG)
  • A brain scan (either CT and MRI)

In Dissociative Seizures, the brain wave recordings during the episode will be normal as compared to abnormal brain wave recordings in people with epilepsy.

Your doctor may ask your family and friends to take home videos on a mobile phone as these can be helpful.

Occasionally, people may need to be admitted to the hospital for the episodes to be seen and the diagnosis to be made.

Often, it may take a long time, even years, to arrive at the correct diagnosis because at times doctors may have thought it was epilepsy at first.

Meeting a specialist doctor and revisiting the diagnosis may be required to arrive at the correct diagnosis

 

 

Why was I told I had Epilepsy?

Dissociative Seizures can often be mistaken for Epilepsy. This is because, to an untrained eye, Dissociative Seizures and Epilepsy can look very similar.

For this reason, some people may be wrongly diagnosed with Epilepsy for several years before a correct diagnosis of Dissociative Seizures is reached. This also means that some people may be treated with medicines for epilepsy for a long time before the correct diagnosis is made, and medicines for Epilepsy are stopped.

Sometimes, people with epilepsy can have Dissociative Seizures as well. To understand how a diagnosis of Dissociative Seizures is reached, click here.

 

How can I be sure this is the right diagnosis?

Although Dissociative Seizures (non-epileptic attack disorder) can look like Epilepsy, specialists are able to tell them apart using a combination of methods.

The doctor may use detailed descriptions of the attacks from patients and those witnessing the attacks, home videos, brain wave tests (EEG), and brain scans (CT and MRI) to reach the diagnosis. At times, patients may need to be admitted to the hospital for observation of the attacks.

The brain waves (EEG) stay normal in dissociative seizures but are abnormal in epileptic seizures.

Doctors can tell the difference between Dissociative Seizures and Epilepsy by examining the type of movements and other changes in the body, duration, and frequency of attacks, as well as what happens before and after the attacks.

It can be especially difficult to understand the change of diagnosis if you have been told you had epilepsy in the past. However, doctors take extra care and only change the diagnosis when they are confident of the diagnosis of Dissociative Seizures."

What are the tests?

Taking a detailed history of the attacks can often be enough to make the diagnosis of Dissociative Seizures. Doctors ask patients about their experience before, during, and after the episodes. Descriptions of the episodes from families and friends can also be very useful.

Sometimes people may need further tests to confirm the diagnosis and rule out other causes for their symptoms. The tests may include CT and MRI scans, EEG, and ECG. 

At times, patients may need to be admitted to hospital for observation and tests.

To see what happens during an EEG, watch the following short clip.

Editorial Information

Last reviewed: 30/05/2024

Next review date: 30/11/2024

Author(s): INS Neuropsychology QEUH.

Version: 2

Author email(s): ins.neuropsychology@ggc.scot.nhs.uk.

Approved By: NHS GGC

Reviewer name(s): INS Neuropsychology QEUH.