A 48-Year-Old Man With Temporal Lobe Epilepsy and Psychiatric Illness

Devinsky, Orrin

doi:10.1001/jama.290.3.381

Cited by 12 publications

(4 citation statements)

References 73 publications

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“…Fear occurs as an aura among 10-15% of patients with partial seizures,74 and ictal fear is of sudden onset and brief duration 75. Seizures originating from the anteromedial area and cingulate gyrus may cause fear;74 for this reason ictal fear is closely associated with TLE 76,77. Ictal fear is more strongly associated with medial TLE than lateral TLE, occurring in 15-20% and in 10-15% of patients, respectively 77.…”

Section: Clinical Manifestations Of Depression and Anxiety In Pwementioning

confidence: 99%

“…Seizures originating from the anteromedial area and cingulate gyrus may cause fear;74 for this reason ictal fear is closely associated with TLE 76,77. Ictal fear is more strongly associated with medial TLE than lateral TLE, occurring in 15-20% and in 10-15% of patients, respectively 77. Among the symptoms of anxiety disorders experienced by PWE, the interictal symptoms are the easiest to detect because they have no temporal relationship with seizure occurrence 78.…”

Section: Clinical Manifestations Of Depression and Anxiety In Pwementioning

confidence: 99%

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Depression and Anxiety in People with Epilepsy

2014

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Many recent epidemiological studies have found the prevalence of depression and anxiety to be higher in people with epilepsy (PWE) than in people without epilepsy. Furthermore, people with depression or anxiety have been more likely to suffer from epilepsy than those without depression or anxiety. Almost one-third of PWE suffer from depression and anxiety, which is similar to the prevalence of drug-refractory epilepsy. Various brain areas, including the frontal, temporal, and limbic regions, are associated with the biological pathogenesis of depression in PWE. It has been suggested that structural abnormalities, monoamine pathways, cerebral glucose metabolism, the hypothalamic-pituitary-adrenal axis, and interleukin-1b are associated with the pathogenesis of depression in PWE. The amygdala and the hippocampus are important anatomical structures related to anxiety, and γ-aminobutyric acid and serotonin are associated with its pathogenesis. Depression and anxiety may lead to suicidal ideation or attempts and feelings of stigmatization. These experiences are also likely to increase the adverse effects associated with antiepileptic drugs and have been related to poor responses to pharmacological and surgical treatments. Ultimately, the quality of life is likely to be worse in PWE with depression and anxiety than in PWE without these disorders, which makes the early detection and appropriate management of depression and anxiety in PWE indispensable. Simple screening instruments may be helpful for in this regard, particularly in busy epilepsy clinics. Although both medical and psychobehavioral therapies may ameliorate these conditions, randomized controlled trials are needed to confirm that.

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Section: Clinical Manifestations Of Depression and Anxiety In Pwementioning

confidence: 99%

Section: Clinical Manifestations Of Depression and Anxiety In Pwementioning

confidence: 99%

Depression and Anxiety in People with Epilepsy

2014

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“…Postictal fear can last up to 7 days after the seizure. In ictal anxiety, nervousness, fear, anger and irritability can be a partial seizure or an “aura” of a complex partial seizure (Gaitatzis et al 2004); especially among patients with temporal lobe epilepsy (TLE) (10%–15% with lateral foci and 15%–20% with medial foci) (Gloor et al 1982; Devinsky 2003). Ictal foci on other locations have been related to ictal fear (Hermann and Chhabria 1980).…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation of anxiety among patients with epilepsy

López-Gómez

Espínola²,

Ramı́rez-Bermúdez³

et al. 2008

NDT

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Different factors have been related with interictal anxiety, reported in 10%-25% of patients with epilepsy. We determined the frequency of interictal anxiety in 196 patients with active epilepsy in a cross-sectional survey to know which symptoms of anxiety were most frequently reported in patients with epilepsy and to analyze the factors associated with their presence. Patients were assessed with the Beck Depression Inventory (BDI), MontgomeryAsberg Depression Rating Scale (MADRS), and the Hamilton Anxiety Scale (HAMA). Data were analyzed with a logistic regression model. The HAMA ratings revealed that 38.8% experienced signifi cant anxiety symptoms, as defi ned by a rating above 18 points. Use of primidone, depression, cryptogenic, and posttraumatic etiologies signifi cantly predicted anxiety after logistic regression. Symptoms related to higher scores on HAMA were anxious mood, tension, insomnia, intellectual function, depressed mood, cardiovascular and genitourinary symptoms. Further studies should be performed to defi ne the role of psychosocial factors in the development and evolution of anxiety among these patients.

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“…JBPKIHS 2019; 2(2): [28][29][30][31][32][33] (mainly depression) 23% and anxiety disorders 15% as the most common psychiatric comorbidities in seizure cases. 6 Untreated anxiety can have adverse effects on epilepsy management and disease prognosis.…”

Section: A Study Of Anxiety In Epileptic People Attending Out-patientmentioning

confidence: 99%

A Study of Anxiety in Epileptic People Attending Out-Patient Department of Psychiatry, Nepal Medical College Teaching Hospital

Khadka

Chhetri

2019

Jnl. BP Koirala Inst. Health Sci.

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Background: Epilepsy is the most common chronic neurological disease in the general population and affects approximately 1% of the population in the United States. Anxiety disorders are common co morbidity among patients with epilepsy. Incidence of anxiety was found to be 16.7% in patients with epilepsy. This study has tried to evaluate the anxiety disorder in patients with epilepsy attending outpatient department of Nepal Medical College. Objective: To estimate the prevalence of anxiety in outpatients with epilepsy and the sociodemographicprofiles of patients with epilepsy. Methods: It is a descriptive cross-sectional study. The sample comprised of 55 outpatients with epilepsy attending Psychiatry department of Nepal Medical College Teaching Hospital. Informed consent was taken and semi- structured proforma was filled with adequate information. Diagnosis was based on ICD-10 DCR and severity was assessed using Hospital Anxiety and Depression Scale (HADS). Data was evaluated with SPSS 16 and appropriate statistical tools were applied. Results: The study found that a great number of epileptic patients were suffering from comorbidanxiety disorder (36.36%). Also married patients had higher anxiety disorder (57.69%), thus, showed a significant relation based on marital status and anxiety in epileptic patients. Conclusion: Anxiety disorders are common in people with epilepsy. Increased awareness of the clinical presentations of anxiety disorders should be initiated for securing the mental health and quality of life in people with epilepsy.

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A 48-Year-Old Man With Temporal Lobe Epilepsy and Psychiatric Illness

Cited by 12 publications

References 73 publications

Depression and Anxiety in People with Epilepsy

Depression and Anxiety in People with Epilepsy

Clinical presentation of anxiety among patients with epilepsy

A Study of Anxiety in Epileptic People Attending Out-Patient Department of Psychiatry, Nepal Medical College Teaching Hospital

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