The authors conducted EE assessment of families of the ten patients (6 males and 4 females) who had episodes of uncontrollable epileptic attack despite long-term drug therapy (for not less than 3 years) according to Camberwell Family Interview (CFI).
1) EE was assessed high in the families of seven patients and low (onset age<20) in the families of three patients (onset age>20). 2) The families assessed to have high EE were all rated as 3 or over for EOI and were rated either CC>6 (critical type: onset age>10) or W/PR>3 (positive type: onset age, 10-20). 3) Patients living with families of critical type had concomitant splenetic and those living with families of positive type had concomitant crepuscule.
It seems that families of patients are likely to have emotional overinvolvement (self-sacrifice and dedication, extreme overprotection) because of the clinical characteristics of epilepsy that patients have chronic symptoms since the onset in childhood and in some cases have concomitant intellectual disorder but are quite normal when they don't have attack. It seems both of these attitudes can be psychological stress to epileptic patients and may cause a vicious circle of induction of attacks and occurrence of non-attack symptoms.

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We presented a 15-year-old girl who showed psychotic episodes with forced normalization on EEG. She had suffered from a cerebral astrocytoma and surgical removal was performed at the age of 2 years. As she showed astatic seizures and tonic seizures after the operation, valproate, clonazepam, acetazolamide and primidone were given. As the clonic seizures occurred several times a week, she was referred to us for further seizure control. After acetazolamide and primidone had been cut and valproate decreased, the seizure frequency became monthly. At the age of 12 years, surgical removal of the recurrent brain tumor was performed. At the age of 14 years, psychotic episodes began to occur and gradually increased in frequency. Eventually they continued for 5-6 hours a day. After carbamazepine and hydroxyzine had been added and valproate cut, the psychotic episodes disappeared. During the psychotic episodes the seizure activity on scalp EEG disappeared, but reappeared after disappearance of the psychotic episodes.

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Two patients with dreamy state, who had two methods of precipitation and inhibition for the dreamy state, were observed. The methods of inhibition were successful by thinking the other things in both patients. The methods of precipitation were some different by each patient; one patient precipitated dreamy state by recollecting the previous situations of its occurrence, and another patient precipitated it into loss of consciousness by absorbing self into dreamy state. The detailed investigation of our patients and cases from the literatures concluded that dreamy state is divided into emotion, memory and cognition; at first emotion occurs, and then memory and cognition follows. As neurophysiological hypothesis of cortical network, the discharges of amygdala triggers dreamy state and they spread over hippocampus and neocortex.

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A 12-year-old boy with absence of the left internal carotid artery associated with localization-related epilepsy is described. Few pediatric cases of internal carotid artery defect with epilepsy have been reported. The patient was born after an uncomplicated pregnancy, labor, and delivery. Past history was noncontributory. A pediatric neurologist was consulted when he developed recurrent seizures while watching TV. The EEG findings included paroxysmal discharges on the right centro-temporal and occipital areas. There was no flow void image of the cavernous sinus portion of the left internal carotid artery on MRI. MR angiography revealed absence of the left internal carotid artery. The reason for the epileptic focus being observed on the side opposite of the artery defect is unknown.

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