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Introduction: Self-awareness of cognitive, emotional, functional, and social performance is critical for compliance with treatment. However, few studies have investigated self-awareness and the associated effects on other cognitive variables in patients with temporal lobe epilepsy (TLE) after surgical treatment., Aim: This study was designed to investigate the prevalence of impaired self-awareness (ISA) in patients with TLE who have undergone surgical treatment. Associated correlations with clinical variables (frequency of seizures before surgery, time elapsed since the epilepsy diagnosis, depression, and anxiety) and verbal and visual episodic memory function and differences between patients with right and left TLE were also investigated., Method: Twenty-three adults with TLE after surgical treatment were assessed with the Patient Competency Rating Scale (PCRS-R-BR), the Rey Auditory Verbal Learning Task (RAVLT), and the Modified Ruche Visuospatial Learning Test (RUCHE-M). Patients were considered to have memory dysfunction if delayed recall as assessed with the RUCHE-M or RAVLT was at or below the 25th percentile. Patients were considered to have ISA if PCRS-R-BR discrepancy scores were at or above the 75th percentile. Underestimated cognitive ability (UCA) was defined as a PCRS-R-BR discrepancy percentile score ≤25. Results were analyzed using frequency, Spearman correlation, regression analyses, and the Mann-Whitney test., Results: Frequency analysis of the total sample indicated ISA in 39.13% of patients (n = 9), UCA in 39.13% of patients (n = 9), and impaired verbal and/or visual memory performance in 69.56% of patients (n = 16). Moderate positive correlations were found between the frequency of seizures before surgical treatment and relatives' reports, as well as between the duration of time that had elapsed since the epilepsy diagnosis and patient reports. Negative and moderate correlations were found between the frequency of seizures and the discrepancy score, as well as between depression and patient reports. No differences in PCRS-R-BR were found between patients with right vs. left TLE. No clinical variables significantly predicted self-report or self-awareness., Conclusion: Patients with TLE exhibit various patterns of ISA and negative effects on cognitive function after surgical treatment. Emotional factors and relatives' reports must be considered when assessing these patients., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Although video-EEG monitoring has revolutionized the diagnosis of psychogenic nonepileptic seizure (PNES), the etiology of this condition remains poorly understood. This article is a critical review of studies on the prevalence of traumatic events, abuse, and/or posttraumatic stress disorder (PTSD) in patients with PNES. Searches carried out on MEDLINE (1966-2004) and Web of Science (1945-2004) identified 17 relevant studies. PNES samples showed very high rates of trauma (44-100%) and abuse (23-77%), which were 15-40% higher than those found in control groups. This suggests that traumatic experiences may be a potential risk factor for PNES. PNES samples also showed a higher prevalence of PTSD than control groups, raising the possibility that PNES may arise as a clinical expression of a hypothetical PTSD subtype the core symptoms of which are dissociative. Methodological limitations do not permit the confirmation of these hypotheses. Stronger research designs are needed, such as prospective and case-control studies in both hospital and community settings.