Prevalence of Psychosis in Epilepsy as a Function of the Laterality of the Epileptogenic Lesion

Sherwin, Ira; Peron-Magnan, P.; Bancaud, J; Bonis, A; Talairach, J

doi:10.1001/archneur.1982.00510220019004

Cited by 98 publications

(48 citation statements)

References 20 publications

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“…More agreement among authors concerns the relationship between interictal psychoses and left-sided (65) or bilateral seizure foci (45,65,66). In this regard, although high rates of bitemporal foci were noted in some studies (45,56,67), other authors reported more lateralized foci (63,68).…”

Section: Temporal Lobe Epilepsy and Psychosesmentioning

confidence: 99%

“…Possible risk factors for interictal psychosis in epilepsy include onset of epilepsy before age 20 (47), usually around puberty, a duration of epilepsy greater than 10 years, with a latent period between onset of seizures and onset of psychosis of around 14 years, female gender (71,72), left-handedness (7 1,73), relative absence of febrile convulsions (459, history of complex partial seizures (56,63,74), history of clustering of seizures (45,56), temporal lobe seizure focus, especially left-sided (63,65,75) or bilateral (49, histopathologic findings of abnormal tissue (56), such as gangliogliomas occurring at an early developmental stage and focal neuropathologic lesions (74,75), social deterioration, and AED polytherapy, particularly with high doses of AEDs (52,66). Several authors reported the appearance of psychosis when AEDs were reduced during intensive EEG monitoring in preparation for a surgical approach to intractable seizures (56,76).…”

Section: Risk Factors For Interictal Psychosismentioning

confidence: 99%

“…Studies of epileptic surgical patients demonstrate that people with left-sided temporal lobe epileptogenic lesions are at special risk for development of a schizophrenic-like psychosis (65). The prevalence of sinistrals in the psychotic group can be explained by the hypothesis that a left-sided epileptogenic lesion that develops early, even perinatally, can induce a shift to right cerebral dominance (65).…”

Section: Epileptic Surgical Patients and Psychosismentioning

confidence: 99%

“…The prevalence of sinistrals in the psychotic group can be explained by the hypothesis that a left-sided epileptogenic lesion that develops early, even perinatally, can induce a shift to right cerebral dominance (65).…”

Section: Epileptic Surgical Patients and Psychosismentioning

confidence: 99%

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Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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Summary: This chapter deals with some aspects of psychiatric disturbances in people with epilepsy. Because depression and its treatment are extensively described later in this issue, they are not discussed here. The same pertains to forced normalization. Key Words: Epilepsy-Anxiety-PsychosisDepress ion-Qua1 i ty of 1 i fe-Ps e u do s ei zure s-A n t idepressants-Antipsychotics-Antiepileptic drugs.Although most people with epilepsy lead a normal emotional and cognitive life, neurobehavioral problems can be found in a large number of patients. Higher rates of psychopathology are observed in people with epilepsy relative to the general population (1,2), to other neurologic control groups (3), and to people with chronic nonneurologic disorders (1,4). In particular, increased psychopathology is more common in temporal lobe epilepsy (TLE) than in generalized epilepsy (5). Nevertheless, many issues remain highly controversial, owing in part to several methodologic problems, such as the nosographic approach, the sample examined, the type of control groups, the comparison among nonhomogeneous forms of epilepsy, and the different antiepileptic drugs (AEDs).Psychiatric disturbances can be related either to involvement of brain structures (biologic pathogenesis) or to the chronic characteristics of epilepsy (psychosocial pathogenesis). These psychiatric symptoms may develop in relationship to the seizures (in prodromal, ictal, or postictal periods) but more commonly are present in a chronic interictal condition.The wide range of clinical diversity is related to the anatomic foci, to patterns of spread, and to biologic or psychological differences among patients. Interictal behavioral changes in epilepsy remain controversial and difficult to define, mainly because pathogenesis may be attributable to several factors, such as epilepsy itself, possible brain lesions, the AEDs prescribed, and psychosocial problems (6). On the other hand, the existence of cognitive changes in epilepsy is well established, and Addrress correspondence and reprint requests to Dr. Riccardo Tom at Dipartimento di Neuroscienze, via Cherasco 11, 10126 Torino, Italy.sometimes the presence of cognitive disorders can facilitate the appearance of psychiatric disturbances (7).One of the most widely discussed problems is the incidence of psychiatric pathology in epilepsy, with a wide range of values in the literature related to the type of study. Epilepsy is characterized by a broad spectrum of severity. Ideally, patients for study trials should be selected consecutively from a general epilepsy population, but most epidemiologic studies are carried out in centers for epilepsy and include many refractory subjects who demonstrate a range of pathologic disturbances more severe than those observed in the general population of patients with epilepsy. In community studies, the prevalence of associated psychiatric disorders is low, whereas in specialty referral centers, particularly those serving indigent populations, the prevalence can rise to 25-50%: Among patient...

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Section: Temporal Lobe Epilepsy and Psychosesmentioning

confidence: 99%

Section: Risk Factors For Interictal Psychosismentioning

confidence: 99%

Section: Epileptic Surgical Patients and Psychosismentioning

confidence: 99%

Section: Epileptic Surgical Patients and Psychosismentioning

confidence: 99%

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Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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“…45 Ela se eleva ainda mais quando avaliamos pacientes com epilepsia refratária (entre 8 e 27%). 53 Dependendo da perspectiva sob a qual a relação entre psicose e epilepsia é investigada, encontram-se três tipos de estudos: estudos de prevalência de psicose em pacientes com epilepsia, estudos de prevalência de epilepsia em pacientes psicóticos e estudos de incidência de psicose em pacientes com epilepsia.…”

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Aspectos epidemiológicos e relevância dos transtornos mentais associados à epilepsia

Neto

Marchetti

2005

Rev. Bras. Psiquiatr.

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Aspectos epidemiológicos e relevância dos transtornos mentais associados à epilepsia Epidemiologic aspects and relevance of mental disorders associated with epilepsyResumo Epilepsia é o mais freqüente transtorno neurológico sério, atingindo 50 milhões de pessoas no mundo, 40 milhões delas em países em desenvolvimento. Embora seja um problema predominantemente tratável, nestes países a maioria dos pacientes permanece sem tratamento. Provavelmente, uma das principais causas para isto seja o estigma que atinge as pessoas com epilepsia. Tal fato se agrava ainda mais quando à epilepsia se associam os transtornos mentais, que ocorrem com prevalência aumentada. Os pacientes com epilepsia e transtornos mentais sofrem o que chamamos de "duplo estigma", que freqüentemente os deixa sem tratamento. É provável, particularmente em países em desenvolvimento, que psiquiatras se defrontem com pacientes com epilepsia nos diferentes locais de atendimento. O presente estudo tem como objetivo revisar a epidemiologia dos transtornos mentais associados à epilepsia, determinando a lacuna de tratamento e o impacto destes transtornos na qualidade de vida dos pacientes.Descritores: Epilepsia/epidemiologia; Transtornos mentais/epidemiologia; Saúde pública; Efeitos psicossociais da doença; Qualidade de vida A b s t r a c t Epilepsy is the most common serious neurological disorder. Worldwide, around 50 million people have epilepsy, 40 million of which in developing countries. Though epilepsy is predominantly treatable, most patients in these countries remain without treatment. It is likely that one of the main reasons is the stigma associated with epilepsy. This problem increases when mental disorders are associated with epilepsy, a fairly frequent occurrence. Patients with epilepsy and mental disorders are exposed to a "double stigma", which frequently leads to complete absence of treatment. It is probable that, particularly in developing countries, psychiatrists will be involved with the treatment of people with epilepsy. Our purpose was to review the epidemiology of mental disorders associated with epilepsy, its treatment gap and impact upon quality of life of the patients.

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Cerebral Lateralization

Geschwind¹,

Galaburda²

1985

Arch Neurol

899

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Prevalence of Psychosis in Epilepsy as a Function of the Laterality of the Epileptogenic Lesion

Cited by 98 publications

References 20 publications

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

Aspectos epidemiológicos e relevância dos transtornos mentais associados à epilepsia

Cerebral Lateralization

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