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Issue: Issue 3 (2016)


Case Report

The other face of the seizure

Author(s):
Filipa Martins Alves, Mercedes Alvarez, and Anibal Fonte
Abstract:
Background: Epilepsy coexists with a variety of psychopathological phenomena and the association between psychotic episodes and several epileptic syndromes is long recognized. Epileptic psychotic states can be classified according to their temporal relationship with seizure occurrence into interictal and peri-ictal, and within these pre-ictal, ictal and postictal.
Case Report: We aim to present the case of a 52-year-old male with a temporal lobe epilepsy due to mesial temporal lobe sclerosis. As this is a refractory epilepsy, he was submitted to left hippocampectomy, being seizure free for about three years. Recently, given the stabilization of epilepsy, the antiepileptic drugs were reduced. Contrary to the expectations, the patient recurred to the emergency room presenting postictal psychosis, described by a lucid period followed by confusion, irritability and heteroaggressiveness, as well as sexual disinhibition and delusions. We received the patient in the hospital with no mention that he had had a seizure and that this could be the source of his psychosis.
Discussion: The reported case highlights the significance of the differentiation of the psychosis cases associated with epilepsy, which often remain underdiagnosed or wrongly diagnosed as psychosis not related to this organic pathology.

Keywords: Postictal psychosis, Seizures, Temporal Lobe Epilepsy, Violence.

International Journal of Clinical Neurosciences and Mental Health 2016; 3:3
DOI: http://dx.doi.org/10.21035/ijcnmh.2016.3.3
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