The PNES medical abbreviation stands for psychogenic nonepileptic seizures, episodes that can look like epileptic seizures but are not caused by the abnormal electrical bursts in the brain that define epilepsy. Many clinicians now prefer the names functional seizures or dissociative seizures.
The events are real and involuntary. People are not pretending, and the episodes can be just as disabling as epileptic seizures. PNES is grouped with FND, functional neurological disorder, where the nervous system sends and receives signals in an unusual way even though scans look normal. The term shows up in epilepsy monitoring unit reports, neurology clinic notes and mental health referrals.
At a glance
Stands for
Psychogenic nonepileptic seizuresNewer names
Functional seizures; dissociative seizuresOther forms
PNEE (events), NES, FSConfirming test
Video EEG monitoring of a typical eventGrouped with
Functional neurological disorderSpecialty
Neurology, epileptology, psychiatry, psychologyDo not confuse with
Epileptic seizures; fainting
What the PNES medical abbreviation describes
During a functional seizure a person may shake, stiffen, fall, stare or seem unresponsive. To an onlooker it can look identical to an epileptic seizure. The difference shows on a brain wave recording: during an epileptic seizure the EEG shows typical seizure patterns, while during PNES the brain waves stay without those epileptic changes.
PNES is thought to arise from how the brain handles stress, emotion and bodily sensations, and it is often linked with past trauma, anxiety, depression or other functional symptoms, though not everyone has an identifiable trigger. Some people have both epilepsy and PNES, which is one reason careful testing matters.
How the diagnosis is confirmed
The most reliable way to confirm PNES is video EEG monitoring, often over several days in an epilepsy monitoring unit. Staff try to record one of the person's usual events on camera while the EEG runs. When the typical event happens with no epileptic activity on the recording, and the video features fit, the team can make a confident diagnosis.
Monitoring unit report: "vEEG captured typical event without EEG correlate, c/w PNES." Video EEG recorded one of the patient's usual episodes, the brain waves showed no seizure pattern during it, and the findings are consistent with psychogenic nonepileptic seizures.
Comparing functional seizures with epileptic seizures
Some features lean one way or the other, but none is decisive on its own, which is why recording an event matters.
| Feature | Often in PNES | Often in epileptic seizures |
|---|---|---|
| Eyes during event | Frequently closed | Frequently open |
| Duration | Can be long, sometimes many minutes | Usually brief, a few minutes or less |
| Movements | May wax and wane or vary between events | Tend to follow a set pattern |
| EEG during event | No epileptic activity | Seizure activity in most types |
Treatment approaches
Anti seizure medicines, sometimes listed as AEDs, do not treat functional seizures. If they were started before the diagnosis, the neurologist may plan how to taper them when epilepsy is not also present. The main treatment is psychological therapy, especially cognitive behavioral therapy adapted for functional seizures. A clear, respectful explanation of the diagnosis is considered an important first step, and treating related conditions such as anxiety, depression or post traumatic stress can help.
Words used in notes and why they matter
Older records may say pseudoseizures or nonepileptic attack disorder. Pseudoseizure is now discouraged because it can sound like the events are fake. Current notes favor PNES, functional seizures or dissociative seizures. Students should avoid judgmental language in charting and describe events objectively: what was seen, how long it lasted, and what the EEG showed. Related mental health shorthand includes GAD and MDD, and many more appear on the diagnosis abbreviations hub.
The explanation above is general. Decisions about testing, medicines or therapy for seizures are made with your neurologist and mental health clinician.
Frequently asked questions
What does PNES stand for?
PNES stands for psychogenic nonepileptic seizures. They are seizure like episodes that are not caused by the electrical brain activity of epilepsy. Many clinicians now call them functional or dissociative seizures.
Are PNES episodes fake?
No. They are real, involuntary events that a person does not control. The cause lies in how the brain processes stress and sensations, not in deliberate behavior.
How is PNES diagnosed?
The main test is video EEG monitoring, which records an event on camera while tracking brain waves. If the usual event occurs without epileptic activity on the EEG, the diagnosis can be confirmed.
Do seizure medicines help PNES?
Anti seizure medicines are not effective for functional seizures alone. Psychological therapy is the main treatment, and any change to existing medicines is planned by the neurologist.