Faculty Bibliography

Fatigue is commonly reported as an adverse effect of antiepileptic drugs. Ln other disorders, fatigue has been closely correlated with depression. We examined the frequency of fatigue in epilepsy patients, the contribution of depression to fatigue, and the impact of fatigue upon quality of life. We measured fatigue and depression with the Fatigue Severity Scale (FSS) and Center for Epidemiological Studies-Depression scale (CES-D), respectively in 89 patients with epilepsy at an epilepsy center, 26 depressed controls (DC), and 30 normal health adults (NHA). Patients with epilepsy also completed the Quality of Life in Epilepsy (QOLIE-10) scale. Forty-four percent of epilepsy patients met criteria for severe fatigue, while 52% were depressed. The correlation between fatigue and depression was high among epilepsy patients (r = .60, p = .0001). Both fatigue and depression had an inverse relationship with quality of life in epilepsy (p < .0001). Fatigue in epilepsy is common and is closely associated with depression. Fatigue is associated with significant impairment in quality of life in epilepsy. (C) 1998 by Elsevier Science Inc. All rights reserved

The purpose of this study is to determine the etiologies of seizures in a Veterans' Affairs Medical Center (VAMC) population. We retrospectively reviewed the records of all VAMC patients discharged from the Northport VA

The purpose of this study was to determine whether patient reporting of a relationship between seizure exacerbation and menses helps distinguish premenopausal women with epileptic seizures from those with nonepileptic seizures (NES). We reviewed the responses to the question 'What tends to bring on your seizures?', administered during the initial evaluation of women ages 18-45 years with epileptic seizures (n = 27) and NES (n = 38) at our outpatient clinic. Only one out of 38 women with NES versus 13 of 27 women with epilepsy reported a relationship of seizures with the menstrual cycle (p =.0001). Other precipitants identified for seizure exacerbation such as stress, or emotional upset, did not distinguish these two groups. Patient reporting of a relationship between seizure exacerbation and menses can help distinguish epileptic from NES in premenopausal women. (C) 1998 by Elsevier Science Inc. All rights reserved

Bradyarrhythmias associated with partial seizures are uncommon, with most reported patients having temporal lobe seizure foci on scalp EEG recordings. We report a patient with bradycardia and sinus arrest during a complex partial seizure documented during bilateral subdural EEG and EEG and simultaneous video and EEG recordings. The seizure began in the left temporal lobe and spread to the right temporal region, with bradycardia occurring 55 seconds after ictal onset and asystole after 60 seconds

PURPOSE: We examined the dimensionality of the item content of the Dissociative Experiences Scale (DES) in relation to the clinical diagnosis of conversion nonepileptic seizures (C-NES) versus complex partial epilepsy (CPE). METHODS: The DES was administered to a sex- and age-matched sample of 132 patients with C-NES and 169 with CPE and was factor analyzed with principal components analysis (PCA) with varimax rotation. RESULTS: The mean total DES score was 15.1 in the C-NES group and 12.7 in the CPE group (p = 0.079). The factors obtained by PCA differentiated the CPE and C-NES groups more strongly than did the total DES score. The factor accounting for the most variance, interpreted as 'depersonalization-derealization,' was significantly greater in C-NES than CPE (p = 0.005). An 'absorption-imaginative involvement' factor, which included some of the clinical features of posttraumatic stress disorder was elevated only in subjects reporting histories of childhood abuse (p = 0.001) regardless of the diagnosis of CPE or C-NES. An 'amnestic' factor appearing to represent memory problems related to neurologic impairment showed a trend toward elevation in CPE (p = 0.056) and may have confounded the CPE versus C-NES distinction using total DES scores. CONCLUSIONS: The DES has separate underlying dimensions that appear to relate distinctively to depersonalization and derealization, childhood trauma, and neurologic impairment. The heterogeneous item content of the DES is a potential confound that should be appreciated when this instrument is used to study dissociation in neuropsychiatric populations