Isolated Epileptiform Discharges in Nonepileptic Psychiatric Patients

Boutros, Nash N.

doi:10.1007/978-3-319-04444-6_7

Cited by 1 publication

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“…Panic disorder (PD) is a special condition where the clinical manifestations of the attacks can in fact be a reflection of epileptic activity (like in fear auras) or ESD, a not infrequent challenging clinical differential diagnostic issue 13 . A number of reports have been published suggesting that in some treatment-refractory PD patients AEDs may be useful 14 . Currently, use of AEDs in PD patients is either reserved for patients with demonstrable epileptic activity or as a last resort when nothing else has worked 15 …”

Section: Role Of Epileptiform Activity In Psychiatric Conditionsmentioning

confidence: 99%

The forsaking of the clinical EEG by psychiatry: how justified?

Boutros

2017

CNS Spectr.

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Despite decades of publications attesting to the role of the clinical EEG in diagnosing and managing psychiatric disorders, the procedure remains highly underutilized in the practice of psychiatry. The visually inspected EEG (vEEG) can detect various forms of abnormalities, each with its own clinical significance. Abnormalities can be paroxysmal (i.e., suggestive of an epileptic-like process) or stationary. The most important unanswered question remains the value of detecting epileptiform activity in a nonepileptic psychiatric patient in predicting favorable responses to anticonvulsant treatment. Despite the many shortcomings of vEEG, the available evidence suggests that in the presence of paroxysmal activity in a nonepileptic psychiatric patient a trial of a psychotropic anticonvulsant may be warranted if standard treatment has failed. More research on the contribution of paroxysmal EEG abnormalities to the problem of episodic psychiatric symptoms (e.g., panic attacks, dissociative episodes, repeated violence) is sorely needed. It is postulated that at least some of these conditions may represent an epilepsy spectrum disorder. Similarly, the significance of the presence of a slow-wave activity (whether focal or generalized) also deserves further well-designed research to ascertain the exact clinical significance. Nonetheless, the available data suggest that further medical workup is necessary to ascertain the nature and degree of the pathology when present.

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Section: Role Of Epileptiform Activity In Psychiatric Conditionsmentioning

confidence: 99%