More common features distinguishing epileptic seizures and psychogenic nonepileptic seizures (PNES)*

Sign	Epileptic	PNES
Duration	Usually brief, less than 1 to 2 minutes	Usually longer than 2 minutes
Eyes	Eyes usually open during event	Eyes often closed Forced eye closure suggests PNES
Motor activity	Stereotyped Synchronized Build, progress	Variable Forward pelvic thrusting, rolling side to side, opisthotonus Wax and wane
Vocalization	Uncommon, especially during convulsion, but stereotypical ictal cry (as the chest contracts against a closed larynx) may occur at tonic phase onset of tonic-clonic seizures	Weeping, moaning, or coughing may occur
Prolonged ictal atonia	Very rare	May occur
Incontinence	Common in convulsive seizures	Less common
Autonomic signs	Cyanosis, tachycardia common with major convulsion	Uncommon
Postictal symptoms	Usually confused, drowsy Headache common	May rapidly awaken and reorient Headache rare

* No single feature is sensitive or specific for epileptic versus psychogenic nonepileptic seizures.

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