Every seizure in an epileptic patient is not necessarily a “real” seizure, but may be a “pseudo” seizure. The latter, or “psychogenic seizures”, are emotionally related. The treatment of the two is different. The patient is female, 36 years old. She has been suffering from recurrent seizures for 10 years, with twitching of the limbs for 5 years. 10 years ago, she started to have seizures with a dull, blank expression or fumbling movements that lasted 1-2 minutes and resolved spontaneously. 5 years ago, she had occasional seizures with loss of consciousness and twitching of the limbs. Recently, a new form of seizure appeared in the patient, in which the patient felt a slight dizziness, a sense of blankness, a sense of stopping thinking, or a feeling of tipping over, lasting one second each time, with multiple seizures per day, without nausea and vomiting, without tinnitus, without sweating and pallor. Sometimes the episodes were characterized by blurred vision and floating sensation, accompanied by head swelling and pain. Analysis: From the patient’s medical history and previous EEG data, the diagnosis of epilepsy was clear. The patient has been taking medication without significant adverse effects. The recent seizure pattern is different from the previous ones, and it is necessary to identify whether a new seizure or a so-called “false” seizure has developed. In general, the duration of a seizure is not too short, but is usually within a few tens of seconds to 3 minutes. If the seizure lasts only 1-2 seconds, most seizures are not considered to be epileptic. In addition, the seizure foci are relatively fixed, and the abnormal discharge signals of epilepsy are issued along a fixed pathway of conduction, so seizures are more stereotyped: the form of each seizure is basically the same, unless there are multiple seizure foci in the brain discharging in rotation to produce different forms of symptoms. Thus, variable symptoms would not support seizures. When the patient’s medical history was carefully followed up, he had frequent seizures in crowded and noisy environments and fewer seizures in quiet places. Moreover, he had poor sleep, difficulty in falling asleep, had many dreams at night, mainly nightmares, often waking up with fright, often worrying about the future for no reason, feeling weak and less interested in doing things. To clarify whether the new symptoms were seizures, I reviewed the patient’s EEG. There was no change in the brain waves at the time of the seizure. The patient’s seizure was a “pseudo” seizure, and it was a combination of epilepsy and anxiety disorder. After the addition of anxiolytic drugs, the patient’s mood gradually improved and the symptoms disappeared. Seizure symptoms must meet the characteristics of seizure, repetitive, transient, and stereotyped, and also have the support of the EEG during seizure, in order to determine the “true” seizure. If the above characteristics are not present and the seizure EEG is normal, the seizure can be considered as “pseudoseizure”. Of course, this is not absolute. If the epileptic lesion is deep in the brain, the discharge cannot be transmitted to the surface of the brain, and there may be no change in the EEG when the seizure is recorded on the scalp. It should be recognized that not all symptoms in epileptic patients are related to epilepsy.