The etiology of psychogenic non-epileptic seizures: toward a biopsychosocial model

Neurol Clin. 2009 Nov;27(4):909-924. doi: 10.1016/j.ncl.2009.06.004.


Psychogenic non-epileptic seizures (PNES) are one of the most common differential diagnoses of epilepsy. PNES are poorly understood and often sub-optimally treated. This article summarizes current knowledge about the etiology of PNES. Through describing the interactions of predisposing, precipitating, perpetuating, and triggering factors, an integrated biopsychosocial model of a complex disorder is developed. PNES emerge as a dissociative response to a range of different stressors in vulnerable individuals. Once established, maintaining factors turn a temporary disturbance into a chronically disabling disorder.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Epilepsy / diagnosis
  • Female
  • Humans
  • Male
  • Middle Aged
  • Seizures / etiology*
  • Seizures / psychology*