The relationship of psychiatric illnesses and seizures

Abstract

The relationship between epilepsy and behavioral disturbances has been a subject of controversy since the 19th century. Affective changes may occur prior, during, or after the ictal discharge. Depression is the most prevalent comorbidity. Anxiety, panic attacks, and pseudoseizures may resemble complex partial seizures, and their diagnosis and treatment may be confusing, even to experienced clinicians. Epilepsy-related psychosis is less common, manifesting occasionally with symptoms that are indistinguishable from schizophrenia. There is no clear evidence of a distinct "epileptoid" personality, and interictal violence is extremely rare. Pharmacologic treatment with anticonvulsants remains the cornerstone of treatment. In case of psychiatric comorbidities or refractory seizures, the diagnosis should be re-examined.

Er EEG en nyttig undersøkelse i voksenpsykiatrien?

“…Prolonged epileptic seizures such as in complex partial status epilepticus (CPSE, non-convulsive status) can give rise to long-term impaired consciousness, automatisms, affective changes, confusion, amnesia, fear or schizophreniform disorder symptoms (25). Temporal lobe epilepsy can cause sudden, temporary anxiety or deep despair (3,25). Frontal lobe epilepsy can manifest itself in seizures with bizarre behaviour.…”

“…Epileptic seizures can also be followed by temporary psychiatric symptoms, such as postictal psychosis or postictal depression. There is typically a symptom-free interval of up to one week (3,25).…”

Psychische Störungen bei Epilepsie

“…Epilepsien sind mit einem erhöhten Psychoserisiko verbunden, auch wenn Psychosen im Vergleich zu Depressionen deutlich seltener auftreten (27,48). Nach populationsbasierten Studien liegt die Prävalenz zwischen 2 und 10%, wobei ein Problem bei der Vermischung iktaler, postiktaler und interiktaler Psychosen entsteht (45,49,50,51). Obwohl Psychosen nicht ausschließlich bei Temporallappenepilepsien auftreten, so ist ein temporaler bzw.…”

Effects of surgical side and site on psychological symptoms following epilepsy surgery in adults

“…An estimated 20-40% of patients with epilepsy are diagnosed with psychiatric disturbances, while rates as high as 70% can be seen in patients with pharmacoresistant seizures [1-4]. Mood disorders are the most frequently observed psychiatric diagnoses in patients with epilepsy; the prevalence of depression ranges from 20-55% in this population [5].…”