Recognition of the various expressions of anxiety, psychosis, and aggression in epilepsy.
Anxiety, psychosis, and aggressive behavior are among the frequent comorbid psychiatric disorders identified in patients with epilepsy. Often the clinical manifestations of these disorders vary according to their temporal relation relative to seizure occurrence. Thus, postictal symptoms of anxiety or psychosis differ in severity, duration, and response to treatment with interictal symptomatology. Psychiatric symptomatology in epilepsy can appear concurrently with the seizure disorder and improve or remit on the abolition of epileptic activity. We refer to these as paraictal psychiatric phenomena. Such is the case of aggressive disturbances associated with gelastic seizures caused by hypothalamic hamartomas. In this article, three case studies are presented to illustrate the importance of distinguishing psychiatric symptoms of anxiety, psychosis, and aggression, with respect to their temporal relation with seizure occurrence.
Kanner
Andres M
AM
Department of Neurological Sciences, Rush Medical College, Rush Epilepsy Center at Rush University Medical Center, Chicago, Illinois 60612, USA. akanner@rush.edu
D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology*; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006222:Hamartoma / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008297:Male; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology