Recognition of nonepileptic events.

Nonepileptic paroxysmal events are behavioral, motor, or sensory episodes that do not result from abnormal cortical electrical activity. They can mimic any type of epileptic seizures including simple partial, complex partial, and generalized tonic-clonic seizures. Nonepileptic paroxysmal events may be physiological or psychogenic in nature. In clinical practice, the most common imitators of epileptic seizures are syncope and psychogenic seizures, but transient ischemic attacks, migraine, movement disorders, and metabolic disturbances must be considered at times in the differential diagnosis. In most cases, the clinical history is enough to make a correct diagnosis. The clinical features suggestive of various types of nonepileptic paroxysmal events, together with useful diagnostic tests, will be reviewed.