There are tests that allow the doctor to monitor electrical activity in the patient's brain during seizures. In order to do this this, 10-20 cables are attached (with special adhesives) to the patient's scalp and the electrical activity of the brain is monitored for a specified period of time. This is known as an electroencephalogram, or EEG. Special cameras added to this procedure provides video EEG recording. Video EEG can be done as an outpatient with ambulatory EEG monitoring with video, or as an inpatient, in a hospital room that is equipped with cameras that can observe the patient throughout the EEG monitoring. This way, when the patient has an episode, the doctors can look at both the brain wave data, as well the images on video of the patient's episode and see if they are consistent with either diagnosis (epilepsy or PNES).
In persons with PNES, there are no epileptic brain wave changes on the EEG at the time of the episode.
Therefore, video-EEG is the main tool (or 'gold-standard') to confirm the diagnosis of PNES.