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Epilepsy is characterized by the sudden appearance of motor or sensory phenomena, or an alteration in the state of consciousness. The most common phenomenon is convulsive seizures. The origin of seizures is poorly understood, but they are generally considered to begin as abnormal electrical activity in some part, or parts, of the brain which then kindles a reaction that spreads to other brain regions. There is some controversy about whether epilepsy is always a primary disorder in humans or whether it may sometimes by a secondary consequence of some other abnormal physiological process. There is frequently an association between epilepsy and cerebral arteriovenous malformations (AVMs), abnormal structures in the blood vessels of the brain. While these AVMs often lead to intracranial hemorrhages and complications thereof, there is no indication that an AVM must bleed to cause epilepsy. It is estimated that from 17 to 40 percent of people with nonhemorrhagic AVMs are likely to have epileptic seizures. The authors present two cases that illustrate a curious relation between arteriovenous malformations and epilepsy. The two men, one 20 and one 30, had generalized seizures that began without a warning period or ''aura''. In one case, an arteriovenous malformation was revealed by CT scan; in the other, by angiography. In both cases, electroencephalography (EEG) revealed electrical activity consistent with epilepsy in the region of the cerebral cortex near the AVM, and in both cases both the AVM and the epileptic cortex were surgically removed. This resulted in complete freedom from generalized seizures in both patients. However, both patients subsequently developed partial seizures, which caused confusion and automatisms in one patient and hallucinatory smells in the other. Further EEG examination revealed a temporal lobe source for epileptic activity in both patients, an area distant from the original malformation. Second procedures were performed to extirpate these brain regions, which freed the patients from epileptic activity. The present cases are unique in that the surgical treatment of the AVMs resulted in the disappearance of generalized seizure activity, but apparently unmasked a second focus of epileptic activity causing partial seizures. (Consumer Summary produced by Reliance Medical Information, Inc.)

The prevalence of seizure types among the subpopulation of patients referred for phase I neuropsychological assessment likely differs from the prevalence of specific seizure types within the general seizure population. Understanding the prevalence of clinical diagnoses is critical to maximizing the predictive value of any assessment or diagnostic technique, clinical neuropsychological assessment of patients with seizures being no exception. Data from a series of 835 patients referred for phase I neuropsychological evaluation are used to report the prevalence of specific seizure types, as well as neuropsychological and demographic characteristics. Considerations for clinical neuropsychological research and practice are briefly discussed. [ABSTRACT FROM AUTHOR]

Background: HRQOL is lower in patients with psychogenic non-epileptic seizures (PNES) than in epilepsy patients. Although psychopathology may reduce HRQOL, it is not known whether patients with PNES and epilepsy are similarly affected. We aimed to compare the relationship between psychopathology and HRQOL in PNES and treatment resistant epilepsy., Material/methods: 106 patients with definite diagnosis of PNES or epilepsy were recruited from Epilepsy Monitoring Unit. Patients completed QOLIE-89, Profile of Mood States (POMS), and Adverse Events Profile (AEP). Total Mood Disturbance (TMD) was derived from POMS. We used chi-square and t tests and hierarchical multiple regression to compare HRQOL and its mental status correlates in patients with PNES and epilepsy., Results: Psychiatric history was more prevalent and depression/dejection and TMD were higher in PNES than epilepsy (P<=0.003). PNES patients had a lower adjusted mean HRQOL than epilepsy patients (P<0.01). Mood problems and AEP were strong predictors of HRQOL (P<0.001) and explained the lower HRQOL in PNES vis-l-vis epilepsy. Decreases in HRQOL due to mood problems were similar in both groups. The model explained 62% of the variation in HRQOL., Conclusions: Although more severe psychopathology in PNES explains the lower HRQOL in PNES relative to epilepsy, the negative association between psychopathology and HRQOL remains stable across the groups. PNES patients with severe mood problems show similar, low levels of HRQOL as patients with severe mood problems who have epilepsy. Future studies should examine causal linkages between psychopathology and PNES and other explanations in seizure-related QOL.