What is the expected EEG finding in patients experiencing psychogenic non-epileptic seizures (PNES)?

In patients experiencing psychogenic non-epileptic seizures (PNES), the expected EEG finding is typically normal. This is a key characteristic that distinguishes PNES from epileptic seizures. During an EEG recording, individuals with PNES will not show the epileptiform activity often seen in true epilepsy, which includes spikes, sharp waves, or rhythmic theta and delta activity. Instead, the EEG may reveal a baseline that is completely unremarkable, with no seizure-related abnormalities.

This normal EEG finding is significant in the diagnostic process, as it suggests that the seizures are not of a physiological epileptic origin and may be related to psychological factors. Recognizing this can lead to more appropriate treatment strategies, such as psychological support or therapy, rather than ongoing management with antiepileptic medications.

Understanding this context is essential, as it helps to clarify why a normal EEG is indicative of PNES rather than other types of seizure disorders.