8. Non-Epileptic Paroxysmal Events of Childhood

  1. James W. Wheless
  1. Sucheta M. Joshi

Published Online: 1 NOV 2012

DOI: 10.1002/9781119998600.ch8

Epilepsy in Children and Adolescents

Epilepsy in Children and Adolescents

How to Cite

Joshi, S. M. (2012) Non-Epileptic Paroxysmal Events of Childhood, in Epilepsy in Children and Adolescents (ed J. W. Wheless), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9781119998600.ch8

Editor Information

  1. Department of Pediatric Neurology, University of Tennessee Health Science Center, Le Bonheur Comprehensive Epilepsy Program and Neuroscience Institute, Le Bonheur Children's Hospital, Memphis, TN, USA

Author Information

  1. Pediatrics and Communicable Diseases, Division of Pediatric Neurology, University of Michigan, Ann Arbor, MI, USA

Publication History

  1. Published Online: 1 NOV 2012
  2. Published Print: 23 NOV 2012

ISBN Information

Print ISBN: 9780470741238

Online ISBN: 9781119998600



  • paroxysmal non-epileptic event (PNE);
  • parasomnia;
  • breath-holding;
  • syncope;
  • non-epileptic seizure;
  • hyperekplexia;
  • tic;
  • dyskinesia


Several non-epileptic conditions can have an episodic and paroxysmal presentation, and are common in childhood and adolescence. They have a varied differential diagnosis ranging from physiological conditions to psychiatrically based phenomena. Video telemetry has made the diagnosis of these non-epileptic conditions much easier. Also, when feasible, having parents video tape the events in question can be a useful tool in diagnostic assessment. It is important to accurately identify the non-epileptic phenomena, not only to exclude a diagnosis of epilepsy and save the patient unnecessary treatment with antiepileptic drugs, but also to steer a patient towards appropriate treatments for the condition. This chapter discusses some of the paroxysmal non-epileptic events (PNEs) that are common in the pediatric population, including breath-holding spells, parasomnias, benign paroxysmal positional vertigo of childhood, syncope, PNEs with a psychiatric or behavioral basis, hyperekplexia, alternating hemiplegia, movement disorders, and Sandifer syndrome.