Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy.
OBJECTIVE
S: To identify the prevalence and clinical characteristics of postictal psychiatric (PPS) and cognitive (PCS) symptoms in patients with refractory partial epilepsy and to investigate whether interictal psychiatric and cognitive symptoms worsened in severity during the postictal period.


METHODS
Using a 42-item questionnaire, the authors determined the prevalence and clinical characteristics of PPS and PCS that occurred after >50% of seizures in 100 of 114 consecutive patients with refractory partial epilepsy during a 3-month period. The postictal period was defined as the 72 hours that followed a seizure. The prevalence of all interictal psychiatric and cognitive symptoms was identified and the frequency with which they worsened postictally determined.


RESULTS
A mean of 2.8 +/- 1.8 PCS (median = 3) and 5.9 +/- 5.3 PPS (median = 5) was identified, which included postictal symptoms of depression (PSD) in 43 patients, anxiety (PSA) in 45, postictal psychotic symptoms (PIP) in 7, hypomanic symptoms in 22, neurovegetative symptoms in 52, and fatigue in 37. Most patients experienced more than one type of PPS. Independently of the occurrence of PPS, 38 patients reported a worsening of interictal psychiatric and cognitive symptoms postictally. A history of depression and anxiety significantly increased the number of PSD, PSA, and PIP.


CONCLUSIONS
Postictal psychiatric symptoms are common among patients with refractory partial epilepsy, and the severity of interictal psychiatric and cognitive symptoms commonly worsens during the postictal period.
Division of Epilepsy, Department of Neurological Sciences, Rush Medical College, Rush University Medical Center, Chicago, IL, USA. Andres_M_Kanner@rush.edu
Andres M
AM
Kanner
Arnoldo
A
Soto
Hilary
H
Gross-Kanner
D000328:Adult; D001007:Anxiety / Q000209:etiology*; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D003221:Confusion / Q000209:etiology; D003863:Depression / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004828:Epilepsies, Partial / Q000150:complications* / Q000503:physiopathology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011618:Psychotic Disorders / Q000453:epidemiology / Q000209:etiology*; D012720:Severity of Illness Index