Contributor:  Katie Sprinkel, MD Educational Pearls: Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause Despite common assumption, PNES are not always volitional  20-40% of those with PNES can also have true epileptic seizures 20-40% True diagnosis requires a video EEG  Characteristics of PNES include: Waxing and waning of the seizure intensity Eyes clenched shut Pelvic thrusting, rolling from side-to-side Ability to respond to verbal stimuli during the seizure  Ability to recall information during the seizure Weeping or stuttering Guarding the face on passive hand drop Characteristics of epileptic seizures: Tongue biting Prolonged postictal state Incontinence Haldol or Zyprexa may be better for PNES and benzodiazepines tend to be better for epileptic seizures References Huff JS, Murr N. Psychogenic Nonepileptic Seizures. 2021 Jan 28. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 28722901. Asadi-Pooya AA. Psychogenic nonepileptic seizures: a concise review. Neurol Sci. 2017 Jun;38(6):935-940. doi: 10.1007/s10072-017-2887-8. Epub 2017 Mar 8. PMID: 28275874.   Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD