Psychogenic non-epileptic seizures in the older adult

Psychogenic non-epileptic seizures (PNES) are classified in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, as a functional neurological symptom disorder. This disorder is often misdiagnosed as epilepsy, with the consequence that older adults may have been treated for years for epilepsy before they learn their seizures are non-epileptic. Video electroencephalography monitoring, which is the standardized approach for ruling out epilepsy, is often performed in a specialized epilepsy monitoring unit where the patient lies in bed 24 hours per day waiting for a seizure to be recorded. The immobility, loss of independence, and anxiety that occurs during the monitoring process can be difficult for older adults. It is important for all nurses to be aware of PNES and to be sensitive to the unique needs of older adults who are experiencing these seizures.