Panic attack vs. seizure: similarities and key differences

  • July 26, 2023
  • 5
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Woman looking stressed on the couch

Have you ever had a panic attack? These are very frightening events where your heart races, and you feel like everything’s spinning out of control (among other symptoms). Panic attacks are common - one in 10 people experience them every year in the US. But how do they relate to epilepsy? And how do you know if you’ve had a panic attack or seizure? 

Let’s compare panic attacks vs seizures to learn about the differences - and how they can affect each other.

What is an epileptic seizure?

An epileptic seizure is a specific medical event which happens when there’s a sudden discharge of electrical activity in the brain. Depending on where in the brain the seizure happens, it can cause many different symptoms. These may include:

  • Losing awareness of the world around you
  • Performing repetitive movements
  • Shouting out
  • Walking around aimlessly
  • Lip smacking
  • Twitching, jerking or shaking
  • Losing muscle tone (so you fall over if standing up)
  • And much more

To be diagnosed with epilepsy, you must have two or more ‘unprovoked’ seizures (meaning it wasn't caused by something outside the brain, like low blood sugar).

What is a panic attack?

A panic attack is a feeling of intense fear that often happens at times when people are feeling extremely stressed. But for some people with panic disorders, the attacks can come on entirely unexpectedly. There are many different symptoms of panic attacks, but they often include:

  • Intense feelings of fear, dread or anxiety
  • Heightened sense of awareness of your own physical symptoms
  • Heart palpitations (you can feel your heart beating)
  • Tense muscles
  • Shortness of breath and trouble breathing
  • Trembling and shaking
  • Lightheadedness

In a panic attack, our bodies go into ‘fight or flight’ mode, but they happen at times when there’s no real danger present. 

People are often unsure that anxiety is causing their panic attacks, so may try to find another explanation. Some people may mistakenly believe they’re having epileptic seizures. This doesn’t mean the panic attacks are not serious or scary events - they’re just not the same as seizures. 

Suggested: What are psychogenic nonepileptic seizures?

Panic attack or seizure: what’s the difference?

A panic attack can look like a seizure - and people with anxiety disorders have sometimes been misdiagnosed as having epilepsy. The only way to definitively diagnose epilepsy is to undergo tests. But the following points highlight some of the main differences between panic attacks and seizures:

  • Length

Panic attacks typically last longer than seizures - from a few minutes, and up to half an hour. Usually, seizures last between a few seconds and two minutes (although it is possible to have much longer episodes). 

  • Consciousness

Most of the time, people having panic attacks are aware of their feelings and their surroundings, and they will also be responsive to people around them. By contrast, most people who have epileptic seizures lose awareness and don’t remember the seizure itself (although people with focal aware seizures do remain partially conscious). 

  • Repetitive movements

Often (but not always) people who have epileptic seizures perform repetitive and uncontrolled movements - such as lip smacking, leg cycling, or jerking. People with panic attacks may thrash their arms or shake, but they don’t tend to do these repetitive movements. 

  • Age the disorder begins

People can begin having anxiety disorders and epilepsy at any age. But it’s much more common to start having epileptic seizures during the first decade of life, in your senior years, or after a head injury. 

By comparison, people are more likely to develop anxiety disorders in their late teens and early adulthood (but they can develop at other times too). 

Related: What’s the difference between epileptic and dissociative seizures?

Can a panic attack look like a seizure? 

Yes, panic attacks can look like seizures. As mentioned above, some people with anxiety disorders do sometimes get misdiagnosed with epilepsy. If you’ve been diagnosed with epilepsy, but suspect you might actually be having panic attacks, seek out a second opinion. 

Can panic attacks cause seizures?

Although anxiety disorders and epilepsy are very different conditions, just over a quarter of people with epilepsy experience high levels of anxiety

This is very understandable. Never knowing when their next seizure will strike, the side-effects of their medication, and frustration that they can’t do the things they did before, all contribute to this sense of anxiety. What is more, some people’s auras can cause them to feel extremely fearful. 

It is also well-known that stress is a major seizure trigger - and having a panic attack is undoubtedly stressful. If you have epilepsy and have a panic attack, this could potentially also trigger a seizure too. 

Dealing with panic attacks and seizures

If you think you’re having seizures or panic attacks, then it’s really valuable to get medical help. A physician will talk to you about your symptoms, ask about what happens before and after the events, and they may perform tests to learn more. 

Whether you’re experiencing panic attacks or seizures (or both), know that there’s plenty of help out there to support you going forward.

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