In a patient with seizures but normal neurological examination and workup, what is a likely diagnosis?

In this scenario, the patient exhibits seizures but has a normal neurological examination and comprehensive workup. This presentation is suggestive of psychogenic non-epileptic seizures (PNES), which are often classified under conversion disorder. Conversion disorder, part of the category of dissociative disorders, involves psychological distress being converted into physical symptoms, which can include seizures that resemble epileptic seizures but lack the neurological basis.

The key aspect here is the presence of seizures without any identifiable organic cause. In conversion disorder, individuals may have seizures triggered by psychological factors rather than by neurological dysfunction. This is distinct from other disorders listed, as obsessive-compulsive disorder, somatic symptom disorder, and social phobia do not typically present with seizure-like activity.

The diagnosis of conversion disorder emphasizes the interplay between psychological factors and physical symptoms, as the disorder is characterized by an involuntary loss of function or abnormal movements, including seizure-like episodes, that cannot be explained by neurological disease, highlighting the patient’s underlying psychological state as a contributory factor.