Psychogenic Non-Epileptic Seizures (PNES) in Children, Teens, and Young Adults: Symptoms, Diagnosis, and Treatment
Psychogenic Non-Epileptic Seizures (PNES), also called functional seizures or dissociative seizures, can be frightening for children, adolescents, young adults, and families. These episodes often look like epileptic seizures but are not caused by the abnormal electrical brain activity seen in epilepsy (Baslet et al., 2020; Albert, 2022).
PNES is a form of Functional Neurologic Disorder (FND). The episodes are real, involuntary, and not under the person’s conscious control (Perez & LaFrance, 2016; Reilly et al., 2023).
With the right diagnosis and treatment—especially psychotherapy and family support—many young people improve significantly (Fobian et al., 2020; Albert, 2022).
At Ezer Psychotherapy, we specialize in evidence-based therapy for adolescents, young adults, and families experiencing complex brain-body conditions like PNES.
What Are Psychogenic Non-Epileptic Seizures?
PNES are seizure-like episodes that resemble epileptic seizures but occur without epileptic electrical activity in the brain.
During an episode, a child or young person may experience:
Shaking or jerking movements
Loss of responsiveness
Collapse or fainting-like episodes
Trembling or muscle spasms
Crying or emotional distress
Episodes lasting several minutes or longer
Events that happen during stress, transitions, conflict, school, sports, or emotional overwhelm
PNES symptoms are not fake, attention-seeking, or intentional. They are a real brain-body response involving nervous system dysregulation (Perez & LaFrance, 2016; Albert, 2022).
Why PNES Often Appears in Adolescence and Young Adulthood
PNES commonly develops during childhood, adolescence, or young adulthood. This is a time when the brain is still developing and young people face increasing academic, social, athletic, and emotional demands.
Factors that may contribute include:
Chronic stress or anxiety
Academic or athletic pressure
Trauma or adverse life experiences
Bullying or social challenges
Medical illness or injury
Family stress
Emotional overwhelm
Depression, anxiety, or neurodevelopmental concerns
Not every child with PNES has trauma, and trauma is not required for the diagnosis. Children and adolescents with PNES often have co-occurring psychiatric or neurodevelopmental concerns, so careful assessment is important (Hansen et al., 2021; Reilly et al., 2023).
How PNES Is Diagnosed
PNES should be diagnosed by clinicians with expertise in seizures, usually a neurologist or epilepsy specialist.
Diagnosis may include:
A detailed description of the episodes
Parent, patient, school, or witness reports
Smartphone video of events, when available
Neurological evaluation
EEG or video-EEG monitoring
The strongest diagnostic test is video-EEG monitoring, where doctors record a typical event on video while also measuring brain electrical activity. In PNES, the episode occurs without the epileptic brain activity expected during an epileptic seizure (Baslet et al., 2020; Reilly et al., 2023).
A routine EEG that is “normal” does not automatically prove PNES. Some people with epilepsy can have normal EEGs between seizures, and some people can have both epilepsy and PNES. This is why careful medical evaluation matters (Chen & LaFrance, 2016; Baslet et al., 2020).
Are Psychogenic Non-Epileptic Seizures Real?
Yes. PNES episodes are real.
Children and young adults are not faking symptoms. The nervous system is expressing distress through physical symptoms. This does not mean the child is “making it up” or choosing the episodes.
A helpful way to explain PNES is:
The brain is not structurally broken, but the alarm and control systems are misfiring. Treatment helps the brain and body relearn regulation and control.
How Psychotherapy Treats PNES
Psychotherapy is one of the main treatments for PNES. Treatment focuses on helping the brain and nervous system regain healthy regulation.
1. Understanding the Brain–Body Connection
One of the first steps is helping young people understand how stress, attention, emotion, body sensations, and nervous system regulation interact.
Clear education often reduces fear and shame and helps families engage in treatment (Albert, 2022; Reilly et al., 2023).
2. Reducing Nervous System Dysregulation
Therapy may teach:
Grounding skills
Emotion regulation
Stress management
Body awareness
Relaxation strategies
Early warning sign recognition
Recovery plans after episodes
3. Addressing Stress, Anxiety, or Trauma
For some young people, PNES is connected to unresolved stress, anxiety, depression, trauma, or emotional overwhelm. Treatment may include:
Cognitive Behavioral Therapy (CBT)
Trauma-informed therapy
Emotion regulation skills
Family-based interventions
School support planning
CBT-informed approaches and pediatric Retraining and Control Therapy (ReACT) have shown benefit for functional seizures in children and adolescents (Fobian et al., 2020; Watson et al., 2025).
4. Gradual Return to School and Activities
A major goal of treatment is helping young people return to life.
PNES can disrupt school attendance, sports, work, driving decisions, friendships, and independence. Therapy helps young people rebuild confidence while gradually returning to daily routines.
The Role of Family Support
Parents and caregivers play a vital role in recovery.
Families can help by:
Validating that symptoms are real
Avoiding blame or criticism
Staying calm during episodes
Encouraging therapy participation
Supporting normal routines when medically safe
Working with school and medical providers
Avoiding unnecessary emergency responses once a safe plan is in place
Families should also follow the neurologist’s safety guidance, especially until epilepsy and other medical causes have been appropriately evaluated.
Therapy for PNES at Ezer Psychotherapy
At Ezer Psychotherapy, we provide specialized therapy for adolescents, young adults, and families experiencing psychogenic non-epileptic seizures and other functional neurological symptoms.
Our therapists use evidence-based approaches designed to:
Help clients understand PNES and the brain-body connection
Reduce anxiety and nervous system dysregulation
Address emotional stress and trauma
Build coping skills and resilience
Support return to school, sports, work, and daily life
Help families respond calmly and effectively
We offer secure virtual therapy sessions, making it easier for families to access specialized care.
When to Seek Help for PNES
You may want to seek professional support if a child, teen, or young adult experiences:
Seizure-like episodes without a clear epilepsy diagnosis
Episodes triggered by stress or emotional situations
Neurological symptoms that interfere with school or daily functioning
Continued episodes despite normal neurological testing
Fear, avoidance, or loss of confidence after episodes
Anxiety, depression, trauma symptoms, or family distress
Seek urgent medical care for a first seizure-like episode, injury, breathing problems, prolonged unresponsiveness, suspected overdose, new neurological weakness, or any event that is different from the person’s known pattern.
Get Support for Psychogenic Non-Epileptic Seizures
PNES can feel overwhelming, but recovery is possible. With proper diagnosis, psychotherapy, family support, and coordinated care, many young people regain confidence and return to normal functioning.
If your child, teen, or young adult is experiencing PNES, Ezer Psychotherapy is here to help.
Learn more about our services or schedule a consultation with Ezer Psychotherapy today.
References
Albert, D. V. F. (2022). Psychogenic nonepileptic seizures in children and adolescents. Seminars in Pediatric Neurology, 41, 100949.
Baslet, G., Bajestan, S. N., Aybek, S., et al. (2020). Evidence-based practice for the clinical assessment of psychogenic nonepileptic seizures: A report from the American Neuropsychiatric Association Committee on Research. Journal of Neuropsychiatry and Clinical Neurosciences.
Chen, D. K., & LaFrance, W. C., Jr. (2016). Diagnosis and treatment of nonepileptic seizures. Continuum, 22(1), 116–131.
Fobian, A. D., Long, D. M., Szaflarski, J. P., et al. (2020). Retraining and control therapy for pediatric psychogenic non-epileptic seizures. Annals of Clinical and Translational Neurology.
Hansen, A. S., Rask, C. U., et al. (2021). Psychiatric disorders in children and adolescents with psychogenic nonepileptic seizures. Neurology.
Perez, D. L., & LaFrance, W. C., Jr. (2016). Nonepileptic seizures: An updated review. CNS Spectrums, 21(3), 239–246.
Reilly, C., Menlove, L., Fenton, V., & Das, K. B. (2023). Scoping review and expert-based consensus recommendations for assessment and management of psychogenic non-epileptic seizures in children: A report from the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy. Epilepsia.
Watson, C., et al. (2025). Telehealth provision of Retraining and Control Therapy (ReACT) on cognitive and biopsychosocial functioning in pediatric functional neurological disorder. Journal of Psychosomatic Research.
