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Published Online:https://doi.org/10.1176/jnp.23.4.jnp375

Epilepsy and consciousness are intimately related. Epileptic seizures can cause impairment of consciousness, and the study of how this occurs has informed us about the neural mechanisms that underlie normal consciousness. Moreover, loss of consciousness during seizures increases injury risk and worsens health-related quality of life. The present review describes the current understanding of consciousness and its alterations during ictal events, with implications for the clinical management of patients with epilepsy and relevant neuro-philosophical issues.