WHAT IS THE SIGNIFICANCE OF SUBJECTIVE EVENTS RECORDED DURING LONG-TERM EEG VIDEO MONITORING

Purpose: Purely subjective events, identified as ''seizures'' by patie nts but not accompanied by any clinical or EEG changes, commonly occur during evaluation of patients for intractable epilepsy. We wished to determine the significance of such events. Methods: We analyzed the fr equency of subjective episodes in 379 adults who underwent EEG video m onitoring as part of their evaluation for intractable epilepsy and the relationship of these experiences to epileptic and psychogenic nonepi leptic (NES) seizures. We examined the results of tests of mental abil ity and of emotional, psychosocial, and quality of life (QOL) adjustme nt to determine if individuals with subjective events alone could be d istinguished from those with epileptic seizures only, NES only, or no events, by these measures. Results: We noted subjective events in 39% (147 of 379) of the patients. Of patients with subjective episodes, 52 % also had epileptic seizures, 7% had NES, 1% had both epileptic seizu res and NES, and 40% had subjective events alone. As a group, patients with subjective events alone were slightly more intelligent and less impaired neuropsychologically than people in the other groups, but the y performed more poorly on several important measures of adjustment. C onclusions: The identification of persons with purely subjective episo des apart from all other episodes is important both phenomenologically and from a practical viewpoint.