Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations

Mangas, Mariana Duarte; Martins, Yaroslava; Bravo, Lidia; Matos-Pires, A.

doi:10.1155/2017/3968751

Cited by 2 publications

(1 citation statement)

References 7 publications

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“…Some experiences or phenomena associated with epilepsy, including gelastic-dacrystic seizures, may be misinterpreted as primary psychiatric disorders like major depressive disorder, anxiety disorder or rarely psychotic disorder. 5 Those with gelastic-dacrystic seizures who are cognitively normal before the onset of seizures, often develop behavioural and psychiatric symptoms, including major depressive and anxiety symptoms, and rarely psychosis and cognitive impairment. 6 Dacrystic seizures, characterized by crying, are rare among patients with epilepsy.…”

Section: Discussionmentioning

confidence: 99%

A case report of dacrystic seizures presenting with psychosis

Madathil¹,

Ayirolimeethal²,

Indu³

2020

KJP

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Dacrystic seizures present with sudden bursts of crying and often manifest with comorbid psychiatric symptoms. Here, we present the case of a 27-year-old female with an 11-year history of stereotyped patterns of crying spells, associated with fearfulness, suspicions, hallucinatory behaviour, recurrent suicidal gestures and impairment in functioning. She was treated mostly with antipsychotics, antidepressants and mood stabilizers (for a brief period) irregularly, without adequate improvement. She presented with catatonia, hypokalemia and aspiration pneumonia, following default of medications for one month. With appropriate treatment, her physical condition became stable, when short lasting bouts of recurrent crying spells were observed, followed by confused behaviour and sleep, along with delusions and hallucinations. Her EEG showed epileptiform discharges; brain imaging was normal. She showed good response to anticonvulsants along with antipsychotics. Such unusual presentations of epilepsy and comorbid psychiatric symptoms warrant a high index of suspicion, for proper diagnosis and management.

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Section: Discussionmentioning

confidence: 99%

A case report of dacrystic seizures presenting with psychosis

Madathil¹,

Ayirolimeethal²,

Indu³

2020

KJP

View full text Add to dashboard Cite

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Neuronal excitatory-to-inhibitory balance is altered in cerebral organoid models of genetic neurological diseases

et al. 2021

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The neuro-physiological properties of individuals with genetic pre-disposition to neurological disorders are largely unknown. Here we aimed to explore these properties using cerebral organoids (COs) derived from fibroblasts of individuals with confirmed genetic mutations including PRNPE200K, trisomy 21 (T21), and LRRK2G2019S, which are associated with Creutzfeldt Jakob disease, Down Syndrome, and Parkinson’s disease. We utilized no known disease/healthy COs (HC) as normal function controls. At 3–4 and 6–10 months post-differentiation, COs with mutations showed no evidence of disease-related pathology. Electrophysiology assessment showed that all COs exhibited mature neuronal firing at 6–10 months old. At this age, we observed significant changes in the electrophysiology of the COs with disease-associated mutations (dCOs) as compared with the HC, including reduced neuronal network communication, slowing neuronal oscillations, and increased coupling of delta and theta phases to the amplitudes of gamma oscillations. Such changes were linked with the detection of hypersynchronous events like spike-and-wave discharges. These dysfunctions were associated with altered production and release of neurotransmitters, compromised activity of excitatory ionotropic receptors including receptors of kainate, AMPA, and NMDA, and changed levels and function of excitatory glutamatergic synapses and inhibitory GABAergic synapses. Neuronal properties that modulate GABAergic inhibition including the activity of Na–K-Cl cotransport 1 (NKCC1) in Cl− homeostasis and the levels of synaptic and extra-synaptic localization of GABA receptors (GABARs) were altered in the T21 COs only. The neurosteroid allopregnanolone, a positive modulator of GABARs, was downregulated in all the dCOs. Treatment with this neurosteroid significantly improved the neuronal communication in the dCOs, possibly through improving the GABAergic inhibition. Overall, without the manifestation of any disease-related pathology, the genetic mutations PRNPE200K, T21, and LRRK2G2019S significantly altered the neuronal network communication in dCOs by disrupting the excitatory-to-inhibitory balance.

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Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations

Cited by 2 publications

References 7 publications

A case report of dacrystic seizures presenting with psychosis

A case report of dacrystic seizures presenting with psychosis

Neuronal excitatory-to-inhibitory balance is altered in cerebral organoid models of genetic neurological diseases

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