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.
FAQs
Can you die from a seizure in your sleep?
It is very rare, but it is possible for a seizure during sleep to lead to death in some cases. This may occur due to choking on vomit or aspirating vomit into the lungs while unresponsive and lying down.
Do seizures damage your brain?
Epileptic seizures generally do not cause brain damage if they last less than 5-10 minutes. PNES seizures do not directly damage the brain since they are not caused by electrical disturbances in brain activity.
Can frequent seizures be a sign of a brain tumor?
In some cases, worsening seizures or new onset of seizures in adulthood can be caused by a brain tumor. But this would require investigation with medical imaging tests.
What is the most common cause of death from epilepsy?
The most common cause of death directly related to epilepsy is SUDEP - sudden unexpected death in epilepsy. The exact causes of SUDEP are still unknown.
Can seizure meds cause premature death?
Anti-seizure medications can rarely cause life-threatening allergic reactions and side effects like organ failure in some cases. But overall, the benefits of seizure control usually outweigh the medication risks.
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.
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