Non-Epileptic Seizures: What They Are, How They Differ From Epilepsy, and Support at Home

Non-epileptic seizures look like epilepsy and are not epilepsy. They are one of the commonest symptoms of functional neurological disorder. In fact, the patient guide at neurosymptoms.org says that nearly half of all people brought into hospital with suspected epilepsy turn out to have them. This guide explains what they are and how they differ from epileptic seizures. It also covers how doctors make the diagnosis, and how Starling Homecare supports people who have them at home in Hertfordshire.

The names cause confusion before anything else does. The same attacks have several names: functional seizures, dissociative seizures or attacks, non-epileptic seizures or attacks, and in older notes psychogenic seizures. They are all the same thing. We use non-epileptic seizures here because it is the term families most often arrive with. We use functional seizures where the guide does.

Everything clinical below comes from Professor Jon Stone's guide at neurosymptoms.org, read on 23 September 2026. It describes the condition. It does not diagnose it, and the diagnosis belongs with a doctor who is expert in epilepsy.

What non-epileptic seizures are

An epileptic seizure is a sudden abnormal electrical discharge in the brain. A non-epileptic seizure is not. The guide describes it as a temporary problem in how the nervous system is working, a trance-like state that happens through a process called dissociation. It is explicit that the attacks are not due to another neurological disease. They are real, disabling and frightening, and the guide is equally explicit that you cannot die from them.

There are two main types. In one, the person shakes or thrashes in a way that looks like a generalised epileptic seizure. In the other, the person falls and lies motionless and unresponsive, often for many minutes. Some people have staring episodes instead. Either can go on for a long time, which is one of the features a doctor looks for.

The guide puts the number at around 50,000 people in the UK at any one time. Many had a wrong diagnosis of epilepsy at some point and took epilepsy drugs that did not help. That is often the first clue that something else is going on.

How they differ from epileptic seizures

To a family, and often to paramedics and hospital doctors, the two can look the same. The guide says so plainly. The differences are in the detail. They include the duration, the nature of the movements, how long the person is unresponsive, the appearance of the eyes and mouth, and whether there was a warning. Non-epileptic seizures tend to last longer, and they come with a warning at least half the time. The warning lasts from a few seconds to several hours, and it is often a rising set of physical and dissociative symptoms.

That warning is important for two reasons. It is part of what a specialist uses to make the diagnosis. It is also the foundation of treatment, because learning to recognise and prolong the warning is how people begin to regain control. Our guide to FND treatment explains how that work happens.

How doctors diagnose non-epileptic seizures

The guide is clear that this needs a doctor with expertise in epilepsy. It is equally clear that a video of an attack is the single most useful thing a family can provide. A phone video lets a specialist diagnose accurately in nine cases out of ten. Moreover, a doctor who examines the person during an attack can often be certain. Doctors may use an EEG where there is doubt, ideally combined with video. The EEG shows abnormal patterns in an epileptic seizure and not in a functional one. Brain scans do not diagnose non-epileptic seizures, though they are sometimes done to rule other things out.

For families in Hertfordshire, that means one practical job once someone is safe. Film the next attack if you can, and write down what you saw: how it started, how long it lasted, and what the eyes and mouth were doing. Our guide to what to do when someone has a functional seizure covers the moment itself. It also explains why that description matters so much.

What brings the attacks on

The guide describes a complex problem that arises for different reasons in different people. It lists the situations in which attacks tend to happen. They come out of the blue, at rest when the person is not distracted, with hyperventilation, with feelings of detachment, with stress such as a busy noisy place, and with pain. It also lists what makes them worse, and most of the list is fear. Fear of injury, of embarrassment, of losing control, of not being believed, plus conflicting advice from different clinicians.

That last point is worth holding on to. Frustration, worry and low mood often travel with non-epileptic seizures, but the guide says they are not the cause. So a family that treats the attacks as real from the start removes one of the things that feeds them. Our FND symptoms overview sets seizures alongside the other functional symptoms that often come with them.

How Starling Homecare supports people with non-epileptic seizures at home

Starling Homecare provides visiting, overnight and live-in care across Hertfordshire for people with FND, including those whose main symptom is seizures. Our carers respond to an attack the way the guide describes. They stay calm, give space, put nothing in the mouth, wait for it to pass, and help the person up afterwards without fuss. They also know the person's warning signs from the care plan, and they record each attack in the way a neurologist finds useful.

The wider job is the one the treatment plan asks for. Attacks tend to happen at rest and when the person is not distracted. So a carer who keeps the day moving and holds the routine steady is doing something clinical, not only practical. The same goes for getting the person to their appointments at Danesbury in Welwyn or through the west Hertfordshire community neuro service. Our guide to FND support in Hertfordshire sets out which NHS service covers your town.

We also carry the load the family cannot always carry. Living with someone who may have an attack at any time is exhausting. Therefore our guide to supporting someone with FND at home is for the person doing that. Our FND care at home page describes the service.

Where we support people with FND across Hertfordshire

Each of our areas has its own local team and number, so call the one nearest you:

• St Albans: 01727 324 127
• Harpenden: 01582 824 830
• Welwyn Hatfield: 01707 714 000
• Potters Bar: 01707 714 000
• Hemel Hempstead: 01442 954 137
• Berkhamsted: 01442 954 137
• Tring: 01442 954 137
• Hitchin: 01462 534739
• Hertford: 01920 746779
• Radlett and Shenley: 01923 988 550

Common questions about non-epileptic seizures

Does Starling Homecare provide care at home for someone with non-epileptic seizures in Hertfordshire?

Yes. We provide visiting, overnight and live-in care across Hertfordshire for people with FND, including those whose main symptom is non-epileptic seizures. Our carers respond to an attack the way the patient guide describes. They know the person's warning signs from the care plan, and they record each attack in a form a neurologist can use.

Are the attacks dangerous?

The patient guide says you cannot die from them, and that they are not caused by a disease of the brain. They are still real and frightening, and a fall during an attack can cause injury. So the practical response is to make the space safe and stay with the person until it passes.

Can someone have both epilepsy and non-epileptic seizures?

The guide notes that many people with non-epileptic seizures had a wrong diagnosis of epilepsy at some point. The two can look alike even to clinicians. Whether someone has one, the other or both is a question for a doctor expert in epilepsy. That usually means a video of an attack and sometimes an EEG. Do not stop any epilepsy medicine without that doctor's advice.

Non-epileptic seizures are common, misunderstood and treatable. The first step is a diagnosis by the right person from the right evidence. If you would like to talk about care at home for someone in Hertfordshire who has them, our St Albans office is on 01727 324 127. The functional seizures page at neurosymptoms.org is the source for this guide and is worth reading in full.