What commonly indicates a non-epileptic seizure?

The presence of anterior tongue and lip bites is commonly associated with non-epileptic seizures, particularly because they suggest the occurrence of muscle activity and potential trauma during an episode. In the context of seizures, biting the tongue or lips can occur during convulsive movements, which might suggest a seizure activity; however, in non-epileptic seizures—also known as psychogenic non-epileptic seizures (PNES)—the mechanisms differ from those in epileptic seizures. These seizures often manifest without the involuntary muscle contractions typical of epilepsy, leading to different physical signs.

Intense headaches often follow a seizure rather than indicating one, and they are not specifically emblematic of non-epileptic seizures. Similarly, extreme fatigue is a common subsequent symptom after a seizure, but it does not specifically indicate non-epileptic seizures. Loss of consciousness can occur in both epileptic and non-epileptic seizures and is not exclusive or indicative of either. Thus, anterior tongue and lip bites serve as a more definitive indicator of non-epileptic seizures in this context.