Resetting of brain dynamics: Epileptic versus psychogenic nonepileptic seizures

Balu Krishnan, Aaron Faith, Ioannis Vlachos, Austin Roth, Korwyn Williams, Katie Noe, Joe Drazkowski, Lisa Tapsell, Joseph Sirven, Leon Iasemidis

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


We investigated the possibility of differential diagnosis of patients with epileptic seizures (ES) and patients with psychogenic nonepileptic seizures (PNES) through an advanced analysis of the dynamics of the patients' scalp EEGs. The underlying principle was the presence of resetting of brain's preictal spatiotemporal entrainment following onset of ES and the absence of resetting following PNES. Long-term (days) scalp EEGs recorded from five patients with ES and six patients with PNES were analyzed. It was found that: (1) Preictal entrainment of brain sites was reset at ES (P<0.05) in four of the five patients with ES, and not reset (P=0.28) in the fifth patient. (2) Resetting did not occur (p>0.1) in any of the six patients with PNES. These preliminary results in patients with ES are in agreement with our previous findings from intracranial EEG recordings on resetting of brain dynamics by ES and are expected to constitute the basis for the development of a reliable and supporting tool in the differential diagnosis between ES and PNES. Finally, we believe that these results shed light on the electrophysiology of PNES by showing that occurrence of PNES does not assist patients in overcoming a pathological entrainment of brain dynamics. This article is part of a Supplemental Special Issue entitled The Future of Automated Seizure Detection and Prediction.

Original languageEnglish (US)
Pages (from-to)S74-S81
JournalEpilepsy and Behavior
Issue numberSUPPL. 1
StatePublished - Dec 2011


  • Differential diagnosis
  • Electroencephalography
  • Epileptic seizures
  • Psychogenic nonepileptic seizures
  • Seizure resetting
  • Spatiotemporal brain dynamics

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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