In response to lack of evidence for this syndrome with traditional measures of personality and psychopathology (e.g., MMPI, Rorschach), Bear and Fedio developed a scale (Bear-Fedio Inventory [BFI]) measuring 18 proposed TLE behavioral traits and administered the scale to individuals with TLE, healthy control subjects, and individuals with neuromuscular disorders.11 They found that TLE patients endorsed more traits than both healthy-controls and the medical-contrasting group. The traits that were most discriminating included deepened emotions, circumstantiality, altered religious and sexual concerns, and hypergraphia. After Bear and Fedio's publication, a number of studies investigated the BFI instrument and the hypothesis that these personality and behavioral traits were specific to TLE. By and large, studies support the notion that individuals with TLE exhibit increased behavioral traits on the BFI as compared with healthy-controls and other medical groups. There is also recent work showing that individuals with TLE and bilateral hippocampal atrophy endorse more behavioral traits than those with epilepsy and no-atrophy.12 Similarly, Trimble and Freeman found that individuals with epilepsy and increased religiosity endorsed hypergraphia, greater emotionality, and increased philosophical ideas than individuals with TLE with no religiosity.13 There remains significant controversy about whether the syndrome is distinctive to TLE, given mixed findings when comparing individuals with TLE and patients with psychiatric illness or individuals with generalized epilepsy. Several authors suggest that the BFI measures general psychopathology, rather than a specific TLE syndrome.14,15 Shetty and Trimble carefully reviewed findings from past studies and concluded that most studies support the original Bear and Fedio results that the BFI can differentiate between TLE and other healthy, neurologic, or psychiatric groups. They argued that evidence supports a distinct TLE behavioral syndrome.16 They also suggest that the most consistent traits seem to match up with the original Geschwind syndrome (i.e., religiosity, hypergraphia, hypermoralism), suggesting that further refinement of the scale might be useful. Although only a minority of patients develop these syndromes, at least a subset of individuals with TLE exhibit the characteristic interictal personality traits. Whether these traits are truly specific to TLE remains an open question. The current study examines differences between patients with TLE and NES on the BFI. To-date, no studies have been published describing the BFI in individuals with NES. Understanding interictal personality traits in NES may help differentiate patients with TLE and NES in clinical evaluation. It is also of theoretical interest because both patient groups experience seizure behavior, but only the TLE group has pathologic electrical activity in limbic structures. Given previous BFI study results, we hypothesized that patients with TLE would endorse more symptoms on the BFI than those with NES.