title: Patient awareness of complex partial seizures.
abstract: OBJECTIVE
  To assess self-awareness of complex partial seizures (CPSs) in unselected epilepsy patients through a thorough interview.
  
  
  METHODS
  The study comprised 134 patients at our epilepsy clinic, whose CPSs had been documented by the patient's family members. We investigated the proportion and characteristics of patients unaware of their CPSs compared to those who were, and we monitored the evolution of unawareness of CPSs during the follow-up.
  
  
  RESULTS
  Thirty-one (23%) patients were assigned to the unawareness group (complete, 23; incomplete, 8) and 103 (67%) patients to the awareness group. Patients in the unawareness group were older and had a later age of onset than patients in the awareness group. Interictal epileptiform discharges (IEDs) localized primarily to the temporal region and were more frequently detected in the unawareness group (94%) than the awareness group (55%). Bilateral independent IEDs were found more frequently in the unawareness group than in the awareness group (48% vs. 13%). The bilateral presence of lesions was also more frequent in the unawareness group than the awareness group (16.1% vs. 4.9%). Six (26%) of 23 patients with complete unawareness of their CPSs had experienced awareness of CPSs during the follow-up. Two of these patients even experienced the emergence of de novo aura.
  
  
  CONCLUSIONS
  Our results indicate that a significant number of epilepsy patients are not aware of their CPSs. Unawareness of CPSs may be related to bitemporal dysfunction and a rapid and complete loss of consciousness caused by rapid spread of ictal discharges to the contralateral hemisphere in association with bilateral independent IEDs and bilateral presence of lesions.
authors.affiliation: Department of Neurology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea. kheo@yumc.yonsei.ac.kr
authors.forename: Kyoung
authors.initials: K
authors.lastname: Heo
authors.forename: Sang-Don
authors.initials: SD
authors.lastname: Han
authors.forename: Sung Ryoung
authors.initials: SR
authors.lastname: Lim
authors.forename: Mi Ae
authors.initials: MA
authors.lastname: Kim
authors.forename: Byung In
authors.initials: BI
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000553:Ambulatory Care; D001364:Awareness; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D017029:Epilepsy, Complex Partial / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality / Q000502:physiology; D006304:Health Status; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013702:Temporal Lobe / Q000503:physiopathology