Pseudoseizures after epilepsy surgery

Seizure surgery for medically intractable partial epilepsy in selected patients usually results in dramatically improved seizure control. However, the authors present six patients who, after surgery for refractory complex partial seizures, postoperatively experienced pseudoseizures (also known as nonepileptic seizures), confirmed with EEG monitoring. Three of these patients also had nonepileptic seizures preoperatively that coexisted with their partial epilepsy. Psychiatric assessment revealed that this patient group had several characteristics in common, which suggests that preoperative psychiatric consultation may help identify those patients at risk for developing nonepileptic seizures. Treatment strategies with anticonvulsant medications and behavioral therapy are reviewed.