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Table 1 Signs and symptoms distinguishing psychogenic nonepileptic seizures (PNES) and epileptic seizures (ES)

From: Differential diagnosis between epileptic seizures and psychogenic nonepileptic seizures based on semiology

  Signs and symptoms favoring PNES Signs and symptoms favoring ES
Differences between PNES and ES irrespective of types of events Duration of longer than 10 min  
Vocalization during or after seizures, complex, with affective content Vocalization at the beginning, primitive, has no emotional expression
Ictal crying  
Occurrence from preictal pseudosleep Occurrence from sleep
Ictal eye closure  
Signs and symptoms discriminating Hypermotor and Focal Motor PNES from ES Side-to-side head or body movement (compared with generalised tonic clonic seizures only) Postictal confusion
Pelvic thrusting (frontal lobe partial seizures excluded) Postictal stertorous (generalised tonic clonic seizures only)
Fluctuating course  
Asynchronous jerks (frontal lobe partial seizures excluded)  
Signs and symptoms discriminating Akinetic and Subjective Symptoms Memory recall