A 13-year-old girl with a prior diagnosis of epilepsy presented to the emergency room following a prolonged generalized seizure. Despite ongoing antiepileptic therapy, she experienced recurrent seizures requiring hospitalization. During admission, she showed poor response to benzodiazepines, and further episodes raised suspicion of psychogenic non-epileptic seizures (PNES). Video recordings supported this hypothesis, later confirmed by a third-level paediatric neurology unit. PNES are a diagnostic challenge, particularly in patients with comorbid epilepsy. This case highlights the importance of considering differential diagnoses in drug-resistant epilepsy and the role of specialist referral for accurate diagnosis and treatment.