Can You Die from PNES Seizures? Risks and Prevention Tips

Can You Die from PNES Seizures?

PNES, or psychogenic non-epileptic seizures, can be alarming to witness and experience. But can PNES actually lead to death? While extremely rare, there are some risks to be aware of.

What are PNES Seizures?

PNES seizures are caused by psychological factors, not electrical disturbances in the brain like epileptic seizures. During a PNES episode, the person may shake, jerk, or become immobilized and unresponsive.

While they may look like epileptic seizures, PNES are not associated with abnormal brain activity on EEG tests. They are considered a type of conversion disorder triggered by psychological stress or trauma.

Can You Die Directly from a PNES Seizure?

A PNES seizure itself is not fatal and does not directly cause death. Even prolonged PNES episodes typically do not lead to death or brain damage from lack of oxygen.

However, there are some indirect risks to be aware of. And in very rare cases, severe complications can occur.

Indirect Risks of Injury and Accidents

During a seizure, the person loses awareness and control of their body. This leads to an increased risk of indirect injury:

• Falling and hitting one's head
• Choking from vomiting
• Aspiration of vomit into the lungs
• Drowning if a seizure occurs in water
• Car accidents if driving during a seizure

While rare, these types of accidents can potentially lead to severe injury or even death. Precautions should be taken to prevent accidents during PNES episodes.

Underlying Medical Conditions

In some cases, an individual may have both PNES and epileptic seizures. Or they may have an undiagnosed heart condition or brain disorder that gets aggravated by the seizure activity.

If a seizure triggers an abnormal heart rhythm, severely low oxygen levels, or other medical crisis in a vulnerable individual, the end result could be fatal.

Medication Side Effects

Anti-seizure medications used to treat PNES can also lead to complications in some cases. Side effects like extreme fatigue, dizziness, and cognitive impairment may increase accident risk.

Rarely, severe allergic reactions or drug interactions could occur that lead to medical emergencies.

Suicide Risk

People with PNES have higher rates of depression and anxiety. The seizure episodes themselves can also heighten emotional distress. In severe cases, this could increase the risk of suicidal thoughts or attempts.

However, suicide due to PNES is extremely rare.

Risk Factors for PNES Complications

Not everyone with PNES seizures will experience severe medical complications. But certain factors can increase risk:

Multiple Comorbid Conditions

Having co-existing physical health problems like heart disease, lung disease, or stroke history makes complications more likely if a seizure triggers a crisis.

Brittle Medical State

Some people may be in an unstable medical state where any metabolic stress from a seizure could be dangerous. Examples are unstable diabetes or severe electrolyte imbalances.

High Fall Risk

Older individuals or those prone to falling and injuries could be at risk for serious trauma if they fall during a seizure.

Taking Anti-Seizure Medications

Medications like Depakote, Tegretol, Keppra, etc. do carry side effects and risks that could rarely lead to complications.

Swimming or Bathing Alone

Having a seizure in water when alone and unsupervised can increase drowning risk.

Driving or Operating Machinery

A PNES episode while driving raises the hazard of a severe car crash.

Statistics on PNES-Related Deaths

It's difficult to pin down exact statistics on PNES seizure fatalities. But researchers estimate:

• Only about 0.2% of people with PNES die directly from their seizures
• PNES patients have a 1% higher mortality rate compared to the general population
• The vast majority of these deaths are from natural causes, not accidents
• Suicide accounts for about 25% of the PNES patient deaths

So while complications can occur in rare cases, dying directly due to PNES seizures appears to be extremely uncommon overall.

Prevention of PNES Emergencies

These tips can help lower the risk of serious complications from PNES episodes:

Correct Diagnosis

Getting properly diagnosed can rule out underlying epilepsy or cardiac issues that require specific treatment.

Avoid Anti-Seizure Medications

Unless co-existing epilepsy is present, medications are often not needed for PNES. This avoids medication side effects.

Monitor Overall Health

Stay on top of any other medical conditions through regular doctor visits. Stabilize diabetes, heart disease, and lung disease as much as possible.

Psychotherapy

Counseling to treat underlying psychological trauma and stress may help reduce PNES frequency and depression risk.

Safety Precautions

Avoid swimming, bathing, or driving alone. Install helmets, padding, GPS trackers as needed to prevent injury if a seizure occurs.

Caregiver Education

Ensure caregivers know seizure first aid. But also emphasize that prolonged PNES episodes are not typically dangerous in themselves.

What To Do if a PNES Seizure Lasts Too Long

Most PNES seizures end within 2-3 minutes. But if one lasts over 5 minutes, you can take these steps:

• Time the episode and note any injury
• Roll the person on their side to avoid choking
• Do not restrain or insert anything in their mouth
• Contact a doctor if seizures exceed 10 minutes
• Call emergency services for uncontrolled clusters of seizures
• Perform CPR if breathing or pulse stops

Stay calm, monitor vital signs, and watch for signs of seizure complications. But typically even very prolonged PNES episodes will end without serious effects.

Outlook for People with PNES

While concerning to witness, PNES episodes are rarely fatal. With proper treatment and precautions, most people with PNES live normal lifespans. The focus should be on addressing the root psychological trauma and associated conditions like depression.

In rare cases, complications like accidents, aspiration pneumonia, or dangerous medication reactions can be hazardous. But deaths directly due to PNES seizures are extremely rare overall.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.